Laparoscopic management of renal cystic disease

Abstract

Renal cystic disease, ranging from simple cysts to autosomal dominant polycystic kidney disease (ADPKD), can lead to significant complications such as pain, hypertension, infection, upper urinary tract obstruction, and even renal failure. For patients with preserved renal function, laparoscopic ablation of renal cysts is a recent, though safe and effective alternative to open surgery in patients who have failed conservative measures. Likewise, for symptomatic patients with renal failure, laparoscopic nephrectomy offers a less invasive option to open nephrectomy. Both laparoscopic cyst decortication and laparoscopic nephrectomy offer patients the benefits of minimal intraoperative blood loss, minimal postoperative pain, brief hospital stay, and rapid convalescence while offering a short-term outcome equivalent to open surgery. Further study and follow-up are indicated to assess the long-term effect of these procedures on the outcome of ADPKD with regard to durability of pain relief, preservation of renal function, and impact on renal hypertension.