Hanna R M, Dahniya M H
Department of Diagnostic Radiology and Imaging, Al-Sabah Hospital, State of Kuwait.
AJR Am J Roentgenol. 1996 Sep;167(3):781-3. doi: 10.2214/ajr.167.3.8751700.
The purpose of our study was to determine whether two injections of sclerosant were more effective than a single injection in treating symptomatic simple renal cysts.
We reviewed our results obtained by simple aspiration, by aspiration and a single sclerosant injection, and by aspiration followed by two injections of sclerosing agent over 48 hr. We used 95% alcohol because of its capacity to safely sclerose the epithelial lining of renal cyst walls without damaging the renal parenchyma. After 1-3 min of contact with the alcohol, the epithelial cells lining the cyst become fixed and nonviable; the cyst capsule is penetrated only after 4-12 hr. Longer contact of alcohol with the epithelial cell lining should theoretically result in the nonviability of more epithelial cells and therefore in a lower recurrence rate of cysts after aspiration and sclerotherapy. Our subjects were 46 patients, 30 men and 16 women, treated over a 13-year period. They ranged in age from 38 to 75 years old (mean age, 47 years). Fifty-two cysts were treated. Twenty patients (20 cysts) had simple aspiration only, 15 patients (19 cysts) had a single injection of sclerosant after aspiration, and 11 patients (13 cysts) had two sclerosant injections after aspiration.
Of the 20 patients who had simple aspiration only, 16 cysts had recurred after 2 years. In the single-injection group of patients, we found six recurrences after 2 years. No recurrence has occurred in the group of patients who had two sclerosant injections after aspiration.
Our findings suggest that the results of treating symptomatic simple renal cysts are better in terms of recurrence with two successive injections of 95% alcohol, probably because of the nonviability of more epithelial cells lining the cyst as a result of a longer period of contact with the alcohol. Our sonographic finding of pseudotumors at the sites of previously aspirated giant cysts in two patients is recorded.
我们研究的目的是确定两次注射硬化剂在治疗有症状的单纯性肾囊肿方面是否比单次注射更有效。
我们回顾了通过单纯抽吸、抽吸并单次注射硬化剂以及抽吸后48小时内注射两次硬化剂所获得的结果。我们使用95%酒精，因为它能够安全地硬化肾囊肿壁的上皮内衬而不损伤肾实质。与酒精接触1 - 3分钟后，囊肿内衬的上皮细胞会固定且失去活力；仅在4 - 12小时后囊肿包膜才会被穿透。理论上，酒精与上皮细胞内衬接触时间越长，更多的上皮细胞就会失去活力，因此抽吸和硬化治疗后囊肿的复发率就会越低。我们的受试者为46例患者，其中男性30例，女性16例，治疗时间跨度为13年。他们的年龄在38岁至75岁之间（平均年龄47岁）。共治疗了52个囊肿。20例患者（20个囊肿）仅进行了单纯抽吸，15例患者（19个囊肿）在抽吸后单次注射了硬化剂，11例患者（13个囊肿）在抽吸后注射了两次硬化剂。
仅进行单纯抽吸的20例患者中，有16个囊肿在2年后复发。在单次注射组的患者中，我们发现2年后有6例复发。在抽吸后注射两次硬化剂的患者组中未发生复发。
我们的研究结果表明，连续两次注射95%酒精治疗有症状的单纯性肾囊肿，在复发方面效果更好，这可能是由于与酒精接触时间更长，更多囊肿内衬的上皮细胞失去了活力。我们记录了两名患者先前抽吸的巨大囊肿部位出现假肿瘤的超声检查结果。
