Souftas V D, Kosmidou M, Karanikas M, Souftas D, Menexes G, Prassopoulos P
Department of Radiology and Medical Imaging, Medical School, Democritus University of Thrace, 681 00 Alexandroupolis, Greece.
First Department of Surgery, Medical School, Democritus University of Thrace, 681 00 Alexandroupolis, Greece.
Gastroenterol Res Pract. 2015;2015:489363. doi: 10.1155/2015/489363. Epub 2015 Mar 23.
Aim. To evaluate the feasibility of percutaneous sclerotherapy of symptomatic simple abdominal cysts, using hypertonic saline and bleomycin, as an alternative to surgery. Materials and Methods. This study involved fourteen consecutive patients (ten women, four men, mean age: 59.2 y) with nineteen symptomatic simple cysts (liver n = 14, kidney n = 3, and adrenal n = 2) treated percutaneously using a modified method. Initially CT-guided drainage was performed; the next day the integrity of the cyst/exclusion of extravasation or communications was evaluated under fluoroscopy, followed by two injections/reabsorptions of the same quantity of hypertonic NaCl 15% solution and three-time repetition of the same procedure with the addition of bleomycin. The catheter was then removed; the patients were hospitalized for 12 hours and underwent follow-ups on 1st, 3rd, 6th, and 12th months. Cyst's volumes and the reduction rate (%) were calculated in each evaluation. Results. No pain or complications were noted. A significant cyst's volume reduction was documented over time (P < 0.001). On the 12th month 17 cysts disappeared and two displayed a 98.7% and 68.9% reduction, respectively. Conclusion. This percutaneous approach constitutes a very promising nonsurgical alternative for patients with symptomatic simple cyst, without complications under proper precautions, leading to eliminating the majority of cysts.
目的。评估使用高渗盐水和博来霉素对有症状的单纯性腹部囊肿进行经皮硬化治疗作为手术替代方法的可行性。材料与方法。本研究纳入了连续14例患者（10名女性，4名男性，平均年龄：59.2岁），他们共有19个有症状的单纯性囊肿（肝脏囊肿14个，肾囊肿3个，肾上腺囊肿2个），采用改良方法进行经皮治疗。首先进行CT引导下引流；次日在透视下评估囊肿的完整性/排除外渗或交通情况，随后注射/吸收两次等量的15%高渗氯化钠溶液，并在加入博来霉素后重复相同操作三次。然后拔除导管；患者住院12小时，并在第1、3、6和12个月进行随访。每次评估时计算囊肿体积和缩小率（%）。结果。未观察到疼痛或并发症。随着时间推移，囊肿体积有显著缩小（P < 0.001）。在第12个月时，17个囊肿消失，2个囊肿分别缩小了98.7%和68.9%。结论。这种经皮治疗方法对于有症状的单纯性囊肿患者是一种非常有前景的非手术替代方法，在采取适当预防措施的情况下无并发症，可使大多数囊肿消除。
