軟式輸尿管鏡治療腎盂旁囊腫的應用

謝棨圳 1, 黃琮懿 1

1 高雄醫學大學附設中和紀念醫院泌尿部

Application of Flexible Ureterorenoscopy in Treatment of Parapelvic Cyst

Chi-Chun Hsieh¹, Tsung-Yi Huang¹

¹Department of Urology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan

Abstract Background

Renal cysts are most common benign lesion in kidney, with nearly ten percent of all population had it. Mostly, treatment of symptomatic renal cyst include: aspiration, cyst decortication, or sclerotherapy and even nephrectomy and embolization. Cyst

located in parapelvic region are challenging for laparoscopic cyst unroofing, and even cause symptoms because of obstructive uropathy. We introduced flexible

ureterorenoscopy in treatment of parapelvic cyst and set up standard steps for identifying and draining the cyst and presented our three cases in recent years.

Cases Presentation

3 cases were collected between 2021 to 2022. We developed our steps for identifying parapelvic cyst under endoscopy, including black bluish color and

fluttering over cyst wall. There was no need of patent blue injection nor intraoperative sonography assisting. Cross incision was then made with Holmium laser on cyst wall until fluid drainage from the cyst. Double J stent was indwelled routinely and

removed one to two months later. Follow-up computed tomography one to four months later showed resolution of cyst without recurrence.

Conclusion

Flexible ureterorenoscopy is minimal invasive surgery with rapid recovery after

the operation. It is also useful tool for treating parapelvic cyst rather than laparoscopic intervention and accompanying with ideal safety and efficacy at the same time.

Keywords: Renal cyst, Parapelvic cyst, Flexible ureterorenoscopy