Mohammadi Sichani Mehrdad, Safi Reza, Haghdani Saeid, Khorrami Mohammad Hatef, Alizadeh Farshid, Izadpanahi Mohammad Hossein
Department of Urology, Kidney Transplantation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Urology, Hasheminejad Kidney Research Center, Iran University of Medical Science, Tehran, Iran.
Adv Biomed Res. 2022 May 30;11:38. doi: 10.4103/abr.abr_131_20. eCollection 2022.
The current study aims to assess the effects of the large simple renal cyst (SRC) surgery on renal function for the first time.
This case-series study included 22 patients with larger than 50 mm single SRC who underwent laparoscopic cyst unroofing surgery. Twenty-four-hour urinary protein, creatinine, and volume along with plasma creatinine and estimated glomerular filtration rate (GFR) were measured in patients before and 1 month after surgery. Patients underwent abdominopelvic computed tomography-scan without contrast and parenchymal thickness diameter adjacent to the cyst was measured before and after surgery.
Mean age and weight of patients were 52.2 ± 8.9 years and 77 ± 10.9 akg, respectively. There was no significant difference between plasma creatinine and GFR before and after surgery ( = 0.25 and 0.37, respectively). Twenty-four-hour urinary volume, creatinine, and protein before and after surgery revealed no significant changes ( = 0.37, 0.08, and 0.31, respectively). The mean improvement of parenchymal thickness diameter after surgery was 10.4 ± 0.7 mm which was statistically significant ( = 0.001). However, it was not correlated with the mean estimated GFR change ( = 0.349, = 0.13).
Although laparoscopic unroofing of renal cyst recovered renal parenchymal thickness noticeably, it did not improve renal function significantly; therefore, the latter factor lonely should not be considered a reason for surgery decision. Observation can be chosen as a safe treatment strategy in large SRCs without concern about renal function.
本研究旨在首次评估大型单纯性肾囊肿(SRC)手术对肾功能的影响。
本病例系列研究纳入了22例直径大于50mm的单发SRC患者,这些患者接受了腹腔镜囊肿去顶术。在患者手术前及术后1个月测量24小时尿蛋白、肌酐和尿量,以及血浆肌酐和估计肾小球滤过率(GFR)。患者在手术前后接受腹部盆腔非增强计算机断层扫描,并测量囊肿旁实质厚度直径。
患者的平均年龄和体重分别为52.2±8.9岁和77±10.9kg。手术前后血浆肌酐和GFR无显著差异(分别为=0.25和0.37)。手术前后24小时尿量、肌酐和蛋白无显著变化(分别为=0.37、0.08和0.31)。术后实质厚度直径的平均改善为10.4±0.7mm,具有统计学意义(=0.001)。然而,它与平均估计GFR变化无关(=0.349,=0.13)。
尽管腹腔镜肾囊肿去顶术显著恢复了肾实质厚度,但并未显著改善肾功能;因此,不应仅将后者作为手术决策的理由。对于大型SRC,观察可作为一种安全的治疗策略,无需担心肾功能。