Renal Cystic Echinococcosis: Long-term Outcomes of Percutaneous Treatment.

Abstract Purpose To evaluate long-term outcomes of percutaneous treatment of renal cystic echinococcosis (CE) stratified by the cyst stages according to WHO classification. Materials and methods Between January 1997 and February 2019, 34 patients with renal CE (18 female; mean age:38 years) were treated with three different percutaneous techniques. According to the WHO classification, cysts were classified as CE1, CE2, CE3a and 3b. PAIR (Puncture, Aspiration, Injection, Reaspiration) or standard catheterization was used for dimension-based treatment of CE1 and 3a cysts. MoCaT (Modified Catheterization) was used to treat all the CE2 and 3b cysts. Technical and clinical success, complications, and reduction in the cyst cavities were evaluated. Results Technical success rate was 100%. PAIR, standard catheterization and MoCaT were used to treat 12, 9, and 13 cysts respectively. The only severe adverse event was that a bacterial superinfection occured in the cyst cavity of a patient (3%) treated with MoCaT. Four patients (12%) experienced mild/moderate periprocedural allergic adverse events and managed conservatively. Median durations of hospital stays were 1, 5 and 7 days for PAIR, standard catheterization, and MoCaT respectively. Clinical success rate was 97%. In 1 (3%) of 34 cysts, recurrence was detected and re-treated percutaneously. During 10.5 years of follow-up period 95% volume reduction was achieved. The median final cyst volume was 10mL. Conclusion Renal CE can be successfully treated with minimum adverse events and recurrence rates using appropriate percutaneous techniques selected according to their stage classified by WHO.