[The role of percutaneous puncture alcohol sclerotherapy in the treatment of symptomatic kidney cysts].

OBJECTIVE

The objective of this study was to prospectively evaluate the results of percutaneous alcohol sclerotherapy of symptomatic renal cysts in adults.

MATERIAL AND METHODS

We report a series of 13 patients with a mean age 69 years (47-75 years). The operative indication was pain (9 cases), urinary tract compression (3 cases), very large cyst (1 case). The preoperative assessment (site and dimensions of the cyst) always included ultrasonography (mean diameter: 75 mm). CT scan, for morphological assessment, was performed in 10 cases. The proposed technique consists of intraoperative ultrasound detection followed by puncture of the cyst (under local or general anaesthesia). Insertion of a Malécot tube allows drainage of the cyst with collection of bacteriological and cytological samples and opacification and instillation of an alcoholic solution (98% ethanol) corresponding to one half of the cyst volume, with clamping for 20 minutes. Postoperative surveillance is based on clinical examination and ultrasonography (2 months, 6 months, 1 year).

RESULTS

The procedure was very well tolerated in every case, with external drainage for 48 hours. Clinical and ultrasonographic regression was complete in 90% of cases, with a mean follow-up of 15 months (4-40 months). In two cases, ultrasonographic regression was incomplete (diameter less than 20 mm), but the patients remained asymptomatic.

CONCLUSION

Our results are concordant with those of most studies reported in the literature and this method therefore appears to be a preferred technique for the treatment of this type of renal cyst.