Features of various methods of surgical treatment of kidney cysts

Background. According to foreign and domestic authors, a kidney cyst is one of the most common urological diseases and accounts for up to 20–50%.

Aim. To evaluate the results of various methods of surgical treatment of patients with kidney cysts.

Materials and methods. An analysis was made of 124 case histories of patients who underwent inpatient treatment for symptomatic kidney cysts at the urology department of the Regional Clinical Hospital for the period 2016 to 2019. Also, an analysis of 50 case histories of patients who were hospitalized with the same diagnosis on the basis of the urological department of the emergency hospital for the same period.

Results. Puncture methods of treatment were used only in patients whose cysts radiologically corresponded to categories I and II according to Bosniak. On the basis of the urological department of the emergency hospital, 50 people were operated on in this way, of which 22 (44%) women and 28 (56%) men. The mean age of the patients was 58.2±5 years. Punctures of cysts with evacuation of contents without sclerotherapy – 3 (6%) cases, and puncture of cysts with sclerotherapy with 96% ethyl alcohol – 47 (94%) cases. The average age of patients who underwent surgery in the regional hospital was 56.6±12 years. According to MSCT, cysts of category I according to Bosniak were diagnosed in 96 patients (77.4%), category II in 11 (8.9%), category IIF in 11 patients (8.9%), category III in 6 (4.8%). Laparoscopic excision of the cyst wall was performed in most cases – 109 (88%), laparoscopic nephrectomy was performed in 1 case (0.8%), laparoscopic nephrectomy in 10 (8%) cases, retroperitoneoscopic excision of the cyst wall – 1 (0.8%), open intervention by lumbotomy access – 3 (2.4%), of which nephrectomy was performed in two patients, one patient underwent kidney resection.

Conclusion. Surgical treatment of symptomatic kidney cysts was justified and necessary, as evidenced by the relief of symptoms and verification of cysts suspicious in terms of the likelihood of oncological pathology. Puncture methods of drainage and sclerotherapy are less radical, but justified in patients with high surgical risk. Excision of a cyst or resection of a kidney by laparoscopic access is an effective method of treatment that meets modern safety requirements for treatment.