Recurrence after percutaneous ethanol ablation of simple hepatic, renal, and splenic cysts: is it true recurrence requiring an additional treatment?

Hahn, Seong Tai; Han, Seunghoon; Yun, E. H.; Park, S. H.; Lee, Seung Hoo; Lee, Hongjoo J.; Hahn, Hyung Jin; Hahn, Hyung Min

doi:10.1080/02841850802325974

Cited by 33 publications

(31 citation statements)

References 16 publications

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“…The results were similar to several other studies reported in the international literature [28,29]. In practice, we observed that the aspirated cyst fluid was clear at the beginning, but the aspirated liquid became cloudy after the injection of ethanol.…”

Section: Sclerotherapy For Renal Cystssupporting

confidence: 91%

“…There was a significant difference between the success rate of group A (without ethanol concentration monitoring) and group B (with ethanol concentration monitoring). The 100% (21/21) success rate in group B was significantly better compared with other reports [28,29]. There were several factors that might contribute to the high success rate in our group B.…”

Section: Sclerotherapy For Renal Cystscontrasting

confidence: 47%

“…As a result, catheters had to be placed in the renal cyst for 3 or more days for complete drainage of the transudate by sclerotherapy. Thus, treatmentrelated patient discomfort and the duration of hospital stay were increased [12,28].…”

Section: Sclerotherapy For Renal Cystsmentioning

confidence: 99%

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CT-Guided Sclerotherapy With Ethanol Concentration Monitoring for Treatment of Renal Cysts

Yang

et al. 2011

American Journal of Roentgenology

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Section: Sclerotherapy For Renal Cystssupporting

confidence: 91%

Section: Sclerotherapy For Renal Cystscontrasting

confidence: 47%

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CT-Guided Sclerotherapy With Ethanol Concentration Monitoring for Treatment of Renal Cysts

Yang

et al. 2011

American Journal of Roentgenology

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“…Interestingly, the complete disappearance of the cyst may take as long as 6–12 months, and as a consequence, abdominal US showing residual cyst during this period does not signify failure or recurrence. Initial relapse of a cyst after ethanol sclerotherapy may be secondary to transient, reactive or inflammatory fluid collections, which eventually disappear within several months [57,62].…”

Section: Resultsmentioning

confidence: 99%

Conservative and radiological management of simple renal cysts: a comprehensive review

2012

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What's known on the subject? and What does the study add? Simple renal cysts are a common entity, which may need observation and follow‐up or treatment. The study, for the first time, systematically reviews the indications for follow‐up or radiological treatment of simple renal cysts. To review the conservative and radiological management of simple renal cysts a systematic literature review was performed. Simple renal cysts are commonly found in the adult population. Increasing age is highly associated with its incidence. When they remain asymptomatic they require neither treatment nor follow‐up. When the shape of the cyst is slightly irregular follow‐up is mandatory to exclude malignant progression. Symptomatic cysts require intervention. Ultrasound or computed tomography guidance have been effectively used for cyst puncture. However, simple fluid aspiration is ineffective leading to cyst recurrence. Aspiration should be accompanied with the injection of a sclerosing agent to destroy renal cyst epithelium. Several issues such as the ultimate technique and agent remain to be clarified. High rates of cyst disappearance and long‐lasting cyst volume reduction have been reported with the use of various sclerosants. Ethanol in high concentrations and multiple injections is more commonly used with new agents showing similar efficacy and better complication profile. Studies comparing radiological intervention to surgical excision are lacking. Simple renal cysts may not require treatment when asymptomatic. Radiological intervention with the use of sclerosants needs further evaluation and comparison with other treatment methods.

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“…Intracystic fluid re-accumulation directly following aspiration sclerotherapy is a well-known phenomenon that leads to a restricted cyst reduction in the first week(s) [28]. Although temporary, the cyst may relapse completely following aspiration sclerotherapy [24].…”

Section: Discussionmentioning

confidence: 99%

Predictors of treatment response following aspiration sclerotherapy of hepatic cysts: an international pooled analysis of individual patient data

et al. 2016

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ObjectivesTo identify predictive variables of treatment response following aspiration sclerotherapy of large symptomatic hepatic cysts.MethodsWe collected individual patient data from two tertiary referral centres and included all patients treated with aspiration sclerotherapy of a large (>5 cm), symptomatic hepatic cyst. At six months, clinical response was defined as complete or incomplete. Secondary, suboptimal technical response was defined as lower quartile of cyst reduction. Predictive variables of clinical and technical response were analyzed by logistic regression analysis.ResultsWe included 86 patients (58 ± 10 years; female 90 %). Complete clinical response rate was 55 %. Median cyst diameter and volume reduction were 71 % (IQR 50-87 %) and 98 % (IRQ 88-100 %), respectively. Patients with complete clinical response had a significantly higher cyst reduction compared to incomplete responders (OR 1.02, 95 % CI 1.00-1.04). Aspiration of haemorrhagic cyst fluid (OR 4.39, 95 % CI 1.34-14.39) or a lower cyst reduction at one month (OR 1.06, 95 % CI 1.02-1.10) was associated with a suboptimal technical response at six months.ConclusionComplete clinical response is associated with effective cyst reduction. Aspiration of haemorrhagic cyst fluid or a restricted diameter reduction at one month predicts a suboptimal technical treatment response, however, these variables did not predict symptom disappearance.Key Points• Aspiration sclerotherapy of hepatic cysts shows excellent clinical and technical efficacy. • Optimal clinical responders have a markedly higher cyst reduction. • Haemorrhagic aspirate and a strong fluid reaccumulation predict suboptimal cyst reduction. Electronic supplementary materialThe online version of this article (doi:10.1007/s00330-016-4363-x) contains supplementary material, which is available to authorized users.

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Recurrence after percutaneous ethanol ablation of simple hepatic, renal, and splenic cysts: is it true recurrence requiring an additional treatment?

Abstract: Initial relapse of a cyst following PEA does not signify true recurrence, but transient, reactive, or inflammatory fluid collections which eventually disappear within several months, and thus does not necessitate additional treatment.

Cited by 33 publications

References 16 publications

CT-Guided Sclerotherapy With Ethanol Concentration Monitoring for Treatment of Renal Cysts

CT-Guided Sclerotherapy With Ethanol Concentration Monitoring for Treatment of Renal Cysts

Conservative and radiological management of simple renal cysts: a comprehensive review

Predictors of treatment response following aspiration sclerotherapy of hepatic cysts: an international pooled analysis of individual patient data

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