Puncture and sclerosis of simple renal cysts
2016
OBJECTIVE: evaluate the efficacy and complications of treatment of renal cysts by percutaneous puncture guided by tomography and scle- rosis with intracystic lipiodol. INTRODUCTION: new technologies make it possible to perform minimally invasive surgical procedures more safely than conventional surgery, and in turn create the need for proper indication of procedure and patient selection. Simple renal cysts are very common and usually asymptomatic. When they cause pain, blockage of collecting systems, hard-to-control high blood pressure, infection, or bleeding, they require treatment. Treatment focuses on reducing mass effect by draining the collection and use of sclerosing agents. Usually, sclerosing agents are used in multiple sessions in a single day or on successive days and the results are highly effective. Contraindications for puncture and sclerosis include clotting disorders and small cysts with hilar localization; due to the risk of vascular lesion during puncture. Lipiodol ultra-fluid is a sclerosing agent made up of ethyl esters of iodized fatty acids with iodine concentrations of 48%. MATERIAL AND METHODS: an observational study of 6 patients atten- ded in the Hospital General Dr. Manuel Gea Gonzalez Radiology and Imaging Service with clinical diagnosis, by ultrasound and tomography, of type I and II simple renal cysts based on Bosniak's classification. The indication for percutaneous puncture guided by tomography and sclerosis with Guerbet Lipiodol Ultra-Fluid was pain due to growth of cysts and their mass effect. Three patients were men and three were women, with ages between 30 and 60 years. RESULTS: all the patients were able to undergo sclerotherapy with intra- cystic lipiodol, achieving more than 80% reduction in size; no short- or medium-term complications were reported (in a control 6 months after the procedure). All the patients reported minimal pain in the first 8 hours following the intervention but did not require analgesics.
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