Eissa Ahmed, El Sherbiny Ahmed, Martorana Eugenio, Pirola Giacomo M, Puliatti Stefano, Scialpi Michele, Micali Salvatore, Rocco Bernardo, Liatsikos Evangelos, Breda Alberto, Porpiglia Francesco, Bianchi Giampaolo
Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.
Minerva Urol Nefrol. 2018 Apr;70(2):179-192. doi: 10.23736/S0393-2249.17.02985-X.
Renal cysts are common findings in nearly 10% of general population. According to Bosniak classification, they are classified into simple and complex renal cysts based on their CT characteristics. The majority of simple renal cysts are asymptomatic and require no intervention. Once they become symptomatic or complicated, a non-conservative management should be considered.
This paper is a narrative review of existing manuscripts regarding the non-conservative management of renal cysts. To perform it a search through PubMed was carried out in January 2017. The search was conducted using the following key words: "simple renal cysts," "non-conservative management," "treatment outcomes comparison" etc. EVIDENCE SYNTHESIS: We found 1880 publications that were reviewed by 2 of our authors, and only 46 manuscripts were considered for this review. The most common treatment were investigated and compared to understand the best treatment modality in accordance with patients' and cysts' characteristics. Different treatment modalities are available for the management of simple renal cysts. Surgical exploration is a historical procedure that is no longer used. Simple aspiration without sclerotherapy has high recurrence rate (20-80%), so sclerosants agents are recommended. Ethanol is the most commonly used sclerosing agent with high efficacy up to 97%. Laparoscopy is the gold standard for management in large cysts especially in younger patients. Other techniques are described for parapelvic renal cysts like percutaneous endoscopic ablation and ureteroscopic marsupialization.
Different factors affect the treatment decision including natural history of the cyst, presence of symptoms and/or complications and patients' choice. This literature overview shows that ethanol percutaneous sclerotherapy and laparoscopy are the most commonly reported treatment modality for simple renal cysts.
肾囊肿在近10%的普通人群中很常见。根据博斯尼亚克分类，根据其CT特征可分为单纯性和复杂性肾囊肿。大多数单纯性肾囊肿无症状，无需干预。一旦出现症状或发生并发症，则应考虑采取非保守治疗。
本文是一篇关于肾囊肿非保守治疗的现有文献综述。2017年1月通过PubMed进行了检索。检索使用了以下关键词：“单纯性肾囊肿”、“非保守治疗”、“治疗效果比较”等。证据综合：我们发现了1880篇文献，由两位作者进行了审阅，本综述仅纳入了46篇手稿。研究并比较了最常见的治疗方法，以根据患者和囊肿的特征了解最佳治疗方式。单纯性肾囊肿的治疗有多种方式。手术探查是一种不再使用的传统方法。单纯穿刺抽吸而不进行硬化治疗的复发率很高（20%-80%），因此推荐使用硬化剂。乙醇是最常用的硬化剂，有效率高达97%。腹腔镜检查是大型囊肿尤其是年轻患者治疗的金标准。对于肾盂旁肾囊肿，还描述了其他技术，如经皮内镜消融和输尿管镜下囊肿开窗术。
不同因素会影响治疗决策，包括囊肿的自然病程、症状和/或并发症的存在以及患者的选择。这篇文献综述表明，乙醇经皮硬化治疗和腹腔镜检查是单纯性肾囊肿最常报道的治疗方式。
