Minimally Invasive Surgeries in the Management of Renal Parapelvic Cysts: A Retrospective Comparative Study

Purpose: To compare the efficiency and safety of two minimally invasive surgeries, laparoscopy and flexible ureteroscopy (fURS), in the management of renal parapelvic cysts. Materials and Methods: Between January 2013 and April 2019, patients who suffered from parapelvic cysts and received fURS or laparoscopy at our hospital were recruited for this study. All patients underwent biopsies of the cyst wall. Primary outcome was treatment success, which was defined as symptomatic and radiological. During follow-up, telephone contact and CT scans were used to record any relevant symptoms and any recurrence, respectively. Results: A total of 33 patients (22 in fURS; 11 in laparoscopy) were included in this study. Flank pain prior to the procedures were reported by 14/22 patients and 6/11 in fURS and laparoscopy, respectively (P = .62), and patients had complete pain relief after the operation. The complication rate was significantly lower in the fURS group than in the laparoscopy group (P = .01). Minor complications were observed in 3/22 and 5/11 patients (Grade 1 and 2) in the fURS and laparoscopy group, respectively. All patients were controlled by conservative treatment. However, 1/11 major complication (Grade 3b) was detected in the laparoscopy group and managed by ureteroscopy to remove the obstruction under general anesthesia. Significant differences were found in operative time (P = .01) and postoperative hospital stay (P = .01), while medical expenses were similar between the two groups (P = .42). During follow-up, no recurrence was detected in CT scans. Conclusion: In the management of parapelvic cysts, two minimally invasive surgeries were comparable in efficiency. However, fURS was superior to laparoscopic unroofing with regard to the complication rate, operative time, and postoperative hospital stay.