ULTRASOUND GUIDED PERCUTANEOUS SCLEROTHERAPY OF SIMPLE RENAL CYSTS: PRIMARY SUCCESS AND PROCEDURE SAFETY

Autori:

Dragica Obad Kovačević, Jelena Popić-Ramač, Vinko Vidjak

Sažetak

Svrha: Procijeniti primarni (tehnički) uspjeh i sigurnost procedure perkutane skleroterapije jednostavnih cista bubrega vođene ultrazvučno 96%-tnim etanolom. Bolesnici: 17 bolesnika sa simptomatskim jednostavnim cistama bubrega upućenih od nefrologa ili urologa. Metode: Perkutana punkcija ciste vođena UZ-om s 18 G (gauge) iglom i »pigtail« kateterom debljine 5 F (French), drenaža i inspekcija sadržaja ciste te instilacija etanola. Rezultati: Kod 2 upućena bolesnika punkcija nije učinjena zbog ciste Bosniak II i blizine hilusa bubrega. U 15 bolesnika učinjene su punkcija i drenaža sadržaja ciste. U 4 bolesnika etanol nije instiliran zbog gustog ili krvavog sadržaja ciste, blizine hilusa bubrega i jake boli pri pokušaju instilacije etanola. U 11 bolesnika uspješno je učinjena sklerozacija ciste. Prosječna veličina sklerozirane ciste bila je 8 cm (raspon 6 – 12 cm). Nije bilo znatnijih komplikacija. Zaključak: Perkutana sklerozacija jednostavnih cista bubrega vođena UZ-om lako je izvediva i za bolesnika sigurna metoda, uz prethodnu dobru selekciju cista pogodnih za sklerozaciju.

Summary

Objective: To evaluate primary (technical) success and procedure safety in ultrasound (US)-guided percu­taneous sclerotherapy of simple renal cysts, using 96% ethanol. Patients: 17 patients with symptomatic simple renal cysts referred by nephrologists or urologists. Methods: US-guided percutaneous puncture of the cyst with an 18G (gauge) needle and a »pigtail« 5F (French) catheter, drainage and inspection of the cyst content, and injection of ethanol. Results: Puncture was rejected in two referred patients because of Bosniak II cyst and renal hilum proximity. 15 patients underwent puncture and drainage of the cyst content. In 4 patients ethanol was not injected because: thick or bloody cyst, proximity of renal hilum and severe pain during injection of ethanol. 11 patients underwent sclerotherapy of the cyst. The average size of sclerosed cyst was 8 cm (range 6–12 cm). There were no significant complications. Conclusion: US-guided percutaneous sclerotherapy of simple renal cysts is easy to perform and safe procedure, with the previous good selection of cysts that are suitable for the sclerotherapy.