Treatment of symptomatic simple renal cysts by percutaneous aspiration and ethanol sclerotherapy

Abstract

6 months by clinical assessment, US and intravenous urography. Success was defined as complete when there was total ablation of the cyst and partial when there was a recurrence of less than half the original cyst volume with the resolution of symptoms. Failure was defined as the recurrence of more than half of cyst volume and/or persistent symptoms. RESULTSAfter aspiration and ethanol sclerotherapy, there was microscopic haematuria in two patients and low-grade fever ( < 38.3 ° C) in two, but no major complications. During a mean (range) follow-up of 19 (14-40) months there was complete cyst ablation in 54 cysts and partial resolution in 10. Pain disappeared or was much improved in all patients. After cyst ablation hypertension was well controlled with no medication in all 11 hypertensive patients and haematuria disappeared in all six affected patients. CONCLUSIONSEthanol sclerotherapy for symptomatic simple renal cysts is simple, minimally invasive and highly effective. We recommend it as the first therapeutic option in these patients. KEYWORDSrenal cyst, percutaneous aspiration, sclerotherapy, ethanol OBJECTIVETo report our experience with the use of 95% ethanol as sclerotherapy for symptomatic simple renal cysts. PATIENTS AND METHODSSixty patients with 64 symptomatic simple renal cysts were treated by ultrasonography (US)-guided percutaneous aspiration and injection of 95% ethanol (31 men and 29 women, mean age 46 years, SD 22). The main presentation was renal pain in 34 patients, renal mass in nine, hypertension in 11 and haematuria in six; 24 cysts were on the right, 32 on the left and four bilateral. Patients were evaluated after 1 month and then every

EUS-guided ethanol versus saline solution lavage for pancreatic cysts: a randomized, double-blind study

“…Sample size calculations were made by using the results from previous ethanol lavage of hepatic and renal cysts, [9][10][11][12] published pilot data of ethanol lavage of pancreatic cysts, 24 and expected clinical response to 1 ethanol (80%) lavage compared with 1 saline solution lavage. We estimated that 1 saline solution and 1 ethanol lavage would lead to a 20% and 80% decrease in cyst surface area (calculated for a sphere by using the formula 4pr 2 , where r is the cyst radius), respectively, as measured by EUS.…”

“…Pain is a common phenomenon after ethanol injection of hepatic, renal, and thyroid cysts. [9][10][11][12][13] Acute pancreatitis after ethanol lavage of a pancreatic cyst probably resulted from extravasation of the ethanol out of the cyst and into either the parenchyma or pancreatic duct. In both patients in our study with acute pancreatitis, hospitalization and uneventful discharge occurred after 2 days and 10 days, respectively.…”

“…Ethanol is a commonly used ablative agent for solid liver or adrenal tumors 7,8 and cystic lesions of the liver, 9,10 kidney, 11,12 thyroid gland, 13 and various other sites. [14][15][16] It is widely available, inexpensive, often effective, and relatively easy to administer.…”

EUS-guided ethanol lavage for pancreatic cysts: is it ready for prime time?

“…19,20 In 2005, Gan et al 21 showed that ethanol lavage of pancreatic cystic lesions was safe and effective. Since this study, there have been few experimental studies looking at injection of ethanol 18 or ethanol plus paclitaxel in attempts to ablate pancreatic cysts.…”

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“…Single or multiple sessions have been used, with better results but with higher complications for multiple sessions [363, 366, 373 -377]. The time of exposure (in-dwell time) to ethanol varies from 3 minutes to 4 hours, most often around 20 minutes [352,363,373,375,377,378]. The volume of ethanol injected following aspiration varies from 20 -50 % of the cyst volume and the maximum dose from 75 -200 mL.…”