Estimation of the Efficacy of Retroperitoneoscopic Renal Cysts Deroofing

Introduction. The intensive introduction of modern endovideosurgical techniques creates the prerequisites for the further expansion of minimally invasive surgical interventions. Literature reviews` data on the results of retroperitoneoscopic operations suggest that endovideosurgery in urology has broad prospects for further development.

Purpose of the study. To estimate of the efficacy and safety of the retroperitoneoscopic operations for renal cysts.

Materials and methods. Retroperitoneoscopic operations (renal cysts deroofing) were performed for 152 symptomatic patients with Bosniak I kidney cysts (from 4.4 х 3.8 cm to 14.5 х 14.0 cm). Proposal of the operations were classified according to the technical difficulty as “Easy” in 147 (96.7%) cases (Е: sum of scores 3-5), in 5 (3.3%) cases – «Slightly difficult» (SD: score 7). Statistical analyses of the results performed by the program Microsoft Office Excel 2007, StatSoft Statistica 8.0 with using the Student-Fisher`s criteria.

Results. The mean duration of the operations was 35.7 ± 6.1 min (30-90 min); there were not any intraoperative complications; the mean blood loss was 23.0 ± 4.1 ml (10-100 ml); there was no need for blood transfusion; incidence of postoperative complications were 2.4% - in 4 cases there were manifestation of urinary tract infection during the postoperative period (II category of the complications according to Clavien-Dindo classification); mean hospital stay was 2.2 ± 0.1 day (1-6 days); drainages were removed on second postoperative day; there were not any conversions to open operations and additional procedures in postoperative period.

Conclusions. Retroperitoneoscopic renal cysts deroofing is effective and safe procedure for the treatment of simple kidney cysts. This method has the advantages of minimal invasiveness, minimal complications, short in hospital stay and fast recovery of the patients.

The study did not have sponsorship. The authors have declared no conflicts of interest.

1. Gong EM, Orvieto MA, Lyon MB, Lucioni A, Gerber GS, Shalhav AL. Analysis of impact of body mass index on outcomes of laparoscopic renal surgery. Urology. 2007;69(1):38-43. DOI: 10.1016/j.urology.2006.09.020

2. Inoue T, Kinoshita H, Satou M, Oguchi N, Kawa G, Muguruma K, Murota T, Matsuda T. ComplicaTIons of urologic laparoscopic surgery: a single insTItute experience of 1017 procedures. J. Endourol. 2010;24(2):253-260. DOI: 10.1089/ end.2009.0322

3. Permpongkosol S, Link RE, Su LM, Romero FR, Bagga HS, Pavlovich CP, JarreTT TW, Kavoussi LR. ComplicaTIons of 2,775 urological laparoscopic procedures: 1993 to 2005. J. Urol. 2007;177(2):580-585. DOI: 10.1016/j.juro.2006.09.031

4. Rassweiler JJ, Seemann O, Frede T, Henkel TO, Alken P. Retroperitoneoscopy: experience with 200 cases. J .Urol. 1998; 160(4):1265-9. DOI: 10.1016/s0022-5347(01)62512-62516

5. Ivanov Iu. V., Panchenkov D.N., Baranov A.V., Obolonkov V. Iu., Solov’ev N.A., Shirshov V.N., Chikirev S.V. Laparoscopic treatment of renal cysts. Endoscopic surgery. 2009;15(3):15- 19. (in Russ.) eLIBRARY ID: 13332926

6. Binbay M, Yazici O, Kaba M, Berberoglu Y, Muslumanoglu AY, Tefekli AH. ComplicaTIons associated with urological laparoscopic procedures: an analysis of 313 cases. Turk. J. Urol. 2009;35:17-22.

7. Cadeddu JA, Wolfe JSJr, Nakada S, Chen R, Shalhav A, Bishoff JT, Hamilton B, Schulam PG, Dunn M, Hoenig D, Fabrizio M, Hedican S, Averch TD. ComplicaTIons of laparoscopic procedures aŌ er concentrated training in urological laparoscopy. J. Urol. 2001;166(6):2109-2111. PMID: 11696716

8. Cuvillon P, Nouvellon E, Marret E, Albaladejo P, ForTIer LP, Fabbro-Perray P, Malinovsky JM, Ripart J. American Society of Anesthesiologists’ physical status system: a mulTIcentre Francophone study to analyse reasons for classifi caTIon disagreement. Eur J Anaesthesiol. 2011;28(10):742-747. DOI: 10.1097/EJA.0b013e328348fc9d

9. Di BenedeTT o A, Soares R, Dovey Z, BoTT S, McGregor RG, Eden CG. Laparoscopic radical prostatectomy for highrisk prostate cancer. BJU Int. 2015;115(5):780-786. DOI: 10.1111/bju.12797

10. Fazeli-MaTIn S, Gill IS, Hsu TH, Sung GT, Novick AC. Laparoscopic renal and adrenal surgery in obese paTIents: comparison to open surgery. J .Urol. 1999;162(3 Pt 1):665-669. DOI: 10.1097/00005392-199909010-00005

11. Nouralizadeh A, Lashay A, Radfar MH. Laparoscopic redo-pyeloplasty using verTIcal fl ap technique. Urol. J. 2014;11(2):1532-1533. PMID: 24807781

12. Guillonneau B, Abbou CC, Doublet JD, Gaston R, Janetschek G, Mandressi A, Rassweiler JJ, Vallancien G. Proposal for a “European Scoring System for Laparoscopic OperaTIons in Urology”. Eur. Urol. 2001;40(1):2-6; discussion 7. DOI: 10.1159/000049742

13. Yoon PD, Chalasani V, Woo HH. Use of Clavien-Dindo classifi caTIon in reporTIng and grading complicaTIon safer urological surgical procedures: analysis of 2010 to 2012. J. Urol. 2013;190(4):1271-1274. DOI: 10.1016/j.juro.2013.04.025

14. Bosniak MA. The use of the Bosniak classifi caTIon system for renal cysts and cysTIc tumors. J. Urol. 1997;157(5):1852- 1853. PMID: 9112545

15. Dindo D, DemarTInes N, Clavien PA. Classifi caTIon of Surgical ComplicaTIons A New Proposal With EvaluaTIon in a Cohort of 6336 PaTIents and Results of a Survey. Ann. Surg. 2004;240(2):205-213. DOI: 10.1097/01. sla.0000133083.54934.ae

16. Tefekli A, Altunrende F, Baykal M, Sarilar O, Kabay S, Muslumanoglu AY. Retroperitoneal laparoscopic decorTIcaTIon of simple renal cysts using bipolar PlasmaKineTIc scissors. Int. J. Urol. 2006;13(4):331-336. DOI: 10.1111/j.1442- 2042.2006.01299.x

17. Desai MM, Strzempkowski B, MaTIn SF, Steinberg AP, Ng C, Meraney AM, Kaouk JH, Gill IS. ProspecTIve randomised comparison of transperitoneal versus retroperitoneal laparoscopic radical nephrectomy. J. Urol. 2005;173(1):38-41. DOI: 10.1097/01.ju.0000145886.26719.73

18. Gill IS, MaTIn SF, Desai MM, Kaouk JH, Steinberg A, Mascha E, Thornton J, Sherief MH, Strzempkowski B, Novick AC. ComparaTIve analysis laparoscopic versus open parTIal nephrectomy for renal tumors in 200 paTIents. J. Urol. 2003;170(1):64-68. doi: 10.1097/01.ju.0000072272.02322.ff

19. Meraney AM, Gill IS. Financial analysis of open versus laparoscopic radical nephrectomy and nephroureterectomy. J. Urol. 2012;167(4):1757-1762. PMID: 11912404