Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via S. Sofia 87, 95123, Catania, Italy.
Department of General Surgery and Medical-Surgical Specialties, University of Catania, via S. Sofia, 78, 95123, Catania, Italy.
Updates Surg. 2021 Oct;73(5):1691-1698. doi: 10.1007/s13304-021-01042-2. Epub 2021 Apr 1.
There are currently several strategies for the treatment of symptomatic simple renal cysts, such as aspiration with sclerosants and laparoscopic deroofing. However, no clear indication exists for choosing between them. Here, we carried out a systematic review and a meta-analysis of studies, which compared symptomatic and radiological success between aspiration with sclerotherapy and laparoscopic deroofing. Results were reported as relative risk (RR) and 95% confidence interval (95% CI) using laparoscopic deroofing as control group. The symptomatic and radiological successes were evaluated by 6 and 3 studies, respectively. Notably, aspiration with sclerotherapy was associated with higher risk of failure than laparoscopic deroofing (RR = 2.82; 95% CI = 1.84-4.31 for symptomatic failure; RR = 8.31; 95% CI = 4.22-16.38 for radiological failure). On the other hand, however, aspiration with sclerotherapy was associated with less frequent complications, shorter treatment duration and post-treatment hospital stay, and lower costs. Thus, our work underlines benefits and drawbacks of each intervention, raising the need for further studies to design guidelines for the management of simple renal cysts.
目前有几种治疗有症状单纯性肾囊肿的方法,如抽液加硬化剂治疗和腹腔镜去顶术。然而,对于这两种方法的选择,尚无明确的指征。在这里,我们对比较抽液加硬化剂治疗和腹腔镜去顶术在症状和影像学成功方面的研究进行了系统评价和荟萃分析。结果以相对风险(RR)和 95%置信区间(95%CI)报告,以腹腔镜去顶术为对照组。分别有 6 项和 3 项研究评估了症状和影像学成功。值得注意的是,与腹腔镜去顶术相比,抽液加硬化剂治疗失败的风险更高(症状失败的 RR=2.82;95%CI=1.84-4.31;影像学失败的 RR=8.31;95%CI=4.22-16.38)。然而,抽液加硬化剂治疗与较少的并发症、较短的治疗时间和治疗后住院时间以及较低的成本相关。因此,我们的工作强调了每种干预措施的优缺点,需要进一步的研究来制定单纯性肾囊肿管理指南。