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. 2015 Jun;64(3):230-235.
doi: 10.7727/wimjopen.2014.220. Epub 2015 Sep 14.

Treatment of Parapelvic Cyst by Internal Drainage Technology Using Ureteroscope and Holmium Laser

Q Zhao  1 , S Huang  1 , Q Li  1 , L Xu  1 , X Wei  1 , S Huang  1 , S Li  1 , Z Liu  2
Affiliations

Treatment of Parapelvic Cyst by Internal Drainage Technology Using Ureteroscope and Holmium Laser

Q Zhao et al. West Indian Med J. 2015 Jun.

Abstract
in English, Spanish

Background: The aim of parapelvic cyst treatment is to have complete drainage of cyst fluid and prevent its further compression of the kidney and collective system. This study explores the efficacy and safety of surgical approaches with holmium laser ureteroscopic internal drainage in the treatment of parapelvic cyst.

Methods: The compression effect of parapelvic cyst on the renal collective system was observed by rigid ureteroscope using retrograde ureteroscopic technology. With direct vision, the cyst wall on the obvious parapelvic compression site was cut. The diameter of the cyst wall cut was about 1 cm. The internal drainage was obtained by double-J tubes. When the cyst was in the inferior pole of kidney or where the rigid ureteroscope could not reach, a flexible ureteroscope was used.

Results: In 28 cases of operation, 27 cases were successful. The cyst treatment time was eight to 40 minutes (average 26 minutes). During the operation, no massive haemorrhage, damage of nearby organ and ureter, or other complications happened. Time of follow-up was 10-72 months (average 39 months). The results of follow-up showed that in 22 cases, the cyst disappeared; the diameter of the cyst in four cases was reduced by more than half, and one case recurred.

Conclusion: The treatment of parapelvic cyst by internal drainage operation using holmium laser and ureteroscopy was effective. The operation was safe with few complications.

Antecedentes:: El objetivo del tratamiento de quiste parapélvico es lograr el drenaje completo del líquido del quiste y prevenir su compresión ulterior del riñón y el sistema colectivo. Este estudio explora la eficacia y seguridad de los abordajes quirúrgicos cn drenaje interno mediante ureteroscopia con láser de holmio en el tratamiento de quiste parapélvico.

Métodos:: El efecto de la compresión del quiste parapélvico del sistema colectivo renal fue observado mediante ureteroscopio rígido utilizando la tecnología ureteroscópica retrógrada. Con visión directa, la pared del quiste fue cortada en el sitio obvio de la compresión parapélvica. El diámetro de la pared del quiste cortada era alrededor de 1 cm. El drenaje interno se obtuvo con catéteres doble J. Cuando el quiste estaba en el polo inferior del riñón o donde no podía llegar el ureteroscopio rígido, se utilizaba un ureteroscopio flexible.

Resultados:: De 28 casos de operación, 27 casos tuvieron éxito. El tiempo de tratamiento del quiste fue de ocho a 40 minutos (un promedio de 26 minutos). Durante las operaciones, no hubo hemorragias masivas, daños de órganos y uréteres, u otras complicaciones. El tiempo de seguimiento fue de 10 a 72 meses (un promedio de 39 meses). Los resultados del seguimiento mostraron que en 22 casos, el quiste desapareció. En cuatro casos, el diámetro del quiste se redujo en más de la mitad, y reapareció en uno de los casos.

Conclusión:: El tratamiento de quiste parapélvico por operación de drenaje interno con láser de holmio y ureteroscopia fue eficaz. La operación fue segura con pocas complicaciones.

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Figures

Fig. 1
Fig. 1. The space between the cyst wall and collective system.
Fig. 2
Fig. 2. Compression on the collective system.
Fig. 3
Fig. 3. The process of operation. (A) The part of parapelvic cyst was blue; (B) the parapelvic cyst was excised by holmium laser; (C) part of the cyst was excised; (D) the separation in the cyst was excised; (E) the cyst wall was observed by ureteroscopy by getting into the cyst.
Fig. 4
Fig. 4. One week after operation, the double-J tubes were placed in the cyst.
Fig. 5
Fig. 5. During the follow-up period, the cyst disappeared and the kidney was restored to its normal shape in 22 of 27 cases.
See this image and copyright information in PMC

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