Document Detail

Laparoscopic management of renal cystic disease.
MedLine Citation:
PMID:  11277055     Owner:  NLM     Status:  MEDLINE    
Laparoscopic management of renal cystic disease is a highly effective, safe, and minimally invasive alternative to open surgery and antegrade or retrograde endoscopic procedures. Simple renal cysts can be accessed either transperitoneally or retroperitoneally. Almost all studies of the laparoscopic approach have demonstrated great satisfaction in terms of efficacy, minimal complications, operative time, minimal blood loss, hospital stay, recuperation, and cosmesis over other methods of treating renal cysts. Laparoscopic unroofing of peripelvic cysts is more challenging owing to their proximity to hilar vessels and the collecting system. Such surgery should be considered an advanced laparoscopic procedure. Access may be achieved either transperitoneally or retroperitoneoscopically. The basic principle of adequate exposure is essential for effective treatment. If the cyst is not completely excised, the surgeon must fulgurate the edge and tack perirenal fat in the residual cyst cavity to prevent recurrence and facilitate drainage. Laparoscopic evaluation of complex cysts seems to be sound. The results are promising, and follow-up does not show any increase in peritoneal seeding, tract recurrence, or distant metastases in the small number of neoplasms diagnosed at laparoscopy. Nevertheless, more studies are required with long-term follow-up. Bosniak type IV renal cysts or malignancy in renal cysts can be managed by laparoscopic radical nephrectomy with either access. Laparoscopic cyst marsupialization in patients with ADPKD is the latest emerging indication for laparoscopy in renal cystic disease. This procedure not only effectively reduces pain in some patients but also improves hypertension and stabilizes renal function, delaying renal replacement therapy. Long-term follow-up and further evaluation are needed.
A K Hemal
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Urologic clinics of North America     Volume:  28     ISSN:  0094-0143     ISO Abbreviation:  Urol. Clin. North Am.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-03-29     Completed Date:  2001-04-12     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0423221     Medline TA:  Urol Clin North Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  115-26     Citation Subset:  AIM; IM    
Department of Urology, All India Institute of Medical Sciences, New Delhi, India.
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MeSH Terms
Diagnostic Imaging
Follow-Up Studies
Kidney Diseases, Cystic / diagnosis,  etiology,  surgery*
Postoperative Complications / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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