Fontana D, Porpiglia F, Morra I, Destefanis P
Department of Clinical and Biological Sciences, University of Turin, Italy.
Urology. 1999 May;53(5):904-7. doi: 10.1016/s0090-4295(98)00634-7.
This study sought to show the effectiveness and safety of three repeated alcohol injections for the treatment of simple large renal cysts.
From September 1991 to December 1997 we treated 72 renal cysts. The cyst was drained with an 8F mono J stent. Ninety-five percent sterile ethanol was injected into the cyst and left in place for 20 minutes. Two repeat alcohol injections were performed every 24 hours. After the third alcohol injection, the catheter was removed. To avoid pain in the last 39 patients, 20 mL of 2% lidocaine hydrochloride was injected into the cyst for 15 minutes before the alcohol injections.
The follow-up period ranged from 8 to 83 months (mean 48). One patient underwent surgical intervention because of considerable bleeding in the cystic cavity that occurred after percutaneous drainage. In 1 patient in whom the cystic cavity communicated with the urinary tract, no alcohol injections were performed. After the repeated alcohol injections, the cystic cavity completely disappeared in 68 of the 70 treated cysts at first ultrasound examination. This result, observed at the first ultrasound control observation, remained unchanged during follow-up.
In our experience, percutaneous drainage with three repeated alcohol injections offers a high rate of success without the cost and morbidity associated with other procedures, such as operation or laparoscopy.
本研究旨在证明三次重复酒精注射治疗单纯性大肾囊肿的有效性和安全性。
1991年9月至1997年12月,我们共治疗了72例肾囊肿。用8F单J型支架引流囊肿。将95%的无菌乙醇注入囊肿并留置20分钟。每24小时重复进行两次酒精注射。第三次酒精注射后,拔除导管。为避免后39例患者疼痛,在酒精注射前15分钟向囊肿内注入20 mL 2%盐酸利多卡因。
随访时间为8至83个月(平均48个月)。1例患者因经皮引流后囊肿腔内大量出血而接受手术干预。1例囊肿腔与尿路相通的患者未进行酒精注射。重复酒精注射后,70例接受治疗的囊肿中有68例在首次超声检查时囊肿腔完全消失。首次超声检查时观察到的这一结果在随访期间保持不变。
根据我们的经验,经皮引流并三次重复酒精注射成功率高,且无手术或腹腔镜检查等其他方法所涉及的费用和发病率。