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Advantages of retrograde intrarenal incision versus laparoscopic surgery in management of pararenal cysts: a single-center experience

  • Urology - Original Paper
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Abstract

Purpose

Renal cysts are typically a benign condition, and parapelvic cysts are a type of renal cyst that occur adjacent to the renal pelvis or renal sinus. Parapelvic cysts can increase the risk for injury to adjacent organs or urine leakage during laparoscopic surgery. Flexible ureteroscopes with laser assistance were used to make internal incisions in cysts. Perioperative outcomes of this method were compared with those of laparoscopic surgery.

Methods

Eight-three patients, who underwent surgical treatment for renal cysts at the authors’ medical center between January 2019 and June 2022, were evaluated. Two patients were excluded because they originally opted for RIRS but subsequently converted to laparoscopic surgery. Patients were divided into 2 groups based on surgery type: laparoscopic; and RIRS for internal incision. Outcomes in both groups were analyzed.

Results

Of the 81 patients analyzed, 60 [74% (group 1)] underwent laparoscopic surgery and 21 [26% (group 2)] underwent RIRS for internal incision. The median operative durations for groups 1 and 2 were 87 and 56 min, respectively (p < 0.001). Relative to RIRS, laparoscopic surgery resulted in greater postoperative painkiller use (laparoscopic surgery versus [vs.] RIRS, 43% vs. 19%; p = 0.047). The median length of hospital stay was 2 and 1 days, respectively (p < 0.001).

Conclusions

RIRS demonstrated several advantages over laparoscopic surgery for the internal incision of parapelvic cysts, including shorter operative duration, shorter hospital stay, and less postoperative pain control. These findings may guide the selection of appropriate surgical approaches for patients with renal cysts.

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Funding

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Authors and Affiliations

  1. Institute of Biomedical Science, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan

    Wen-Hsin Tseng & Yow-Ling Shiue

  2. Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC

    Wen-Hsin Tseng, Chia-Chih Hsieh, Steven K. Huang, Chien-Liang Liu, Kau-Han Lee, Kun-Lin Hsieh & Zhi-Hao Chen

  3. Division of Uro-Oncology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan

    Chien-Liang Liu

  4. Department of Urology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan

    Allen W. Chiu

  5. Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan

    Chien-Feng Li

  6. Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan

    Chien-Feng Li

  7. National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan

    Chien-Feng Li

  8. Institute of Precision Medicine, College of Medicine, National Sun Yat-Sen University, No. 70, Lienhai Rd., Kaohsiung, 80424, Taiwan, ROC

    Yow-Ling Shiue

Authors
  1. Wen-Hsin Tseng
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Contributions

WHT, CCH: IRB approval, data collection, analysis, and manuscript preparation, editing, and revision. WHT, SKH, CLL, KHL, KLH, and ZHC: surgery. AWC, CFL, and YLS: Study design and review. All the authors have read and approved the final version of the manuscript submitted for publication.

Corresponding authors

Correspondence to Chia-Chih Hsieh or Yow-Ling Shiue.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval and consent to participate

This study was approved by the Institutional Review Board Committee (Chi Mei Hospital Institutional Review Board, IRB number 11110–007) and the Chimei Hospital Institutional Review Board provided a waiver for informed consent. All experimental protocols involving humans were performed in accordance with institutional guidelines and the Declaration of Helsinki.

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Tseng, WH., Hsieh, CC., Huang, S.K. et al. Advantages of retrograde intrarenal incision versus laparoscopic surgery in management of pararenal cysts: a single-center experience. Int Urol Nephrol 56, 1307–1313 (2024). https://doi.org/10.1007/s11255-023-03881-x

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  • DOI: https://doi.org/10.1007/s11255-023-03881-x

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