신낭종 치료의 비용 효과 분석: 복강경 조대술과 재발로 인해 재시행한 경화요법과의 비교

Abstract

Purpose: Percutaneous aspiration and sclerotherapy for the treatment of symptomatic simple renal cysts is relatively easy and noninvasive, but has the disadvantage of high recurrence rate following therapy. Therefore, we compared the cost effectiveness of laparoscopic, open marsupialization, and repeated sclerotherapy in the treatment of recurrent renal cyst.

Materials and Methods: Data from the patients who were treated for symptomatic simple renal cysts by either laparoscopic cyst marsupialization (n=11), open cyst marsupialization (n=12), or repeated percutaneous cyst aspiration and sclerotherapy (n=12) were reviewed. Only the patients who were followed up for more than 3 months and who demonstrated complete resolution and no recurrence were included. Cyst size, locations, operative times, complications, length of hospital stay, and hospital costs of the three groups were reviewed.

Results: The clinical characteristics, including cyst size, locations and laterality, were not different in each group. Mean follow-up durations were 6.4, 39.3, and 24.3 months in laparoscopy, open, and repeated sclerotherapy groups, respectively. Comparing the laparoscopy with the repeated sclerotherapy group, the operative times (64.1 vs 47.5 minutes, p=0.260), hospital stay (4.4 vs 2.9 days, p=0.051) and costs (1.14 vs 1.01 million won, p=0.091) were no statistical differences. Operative times (91.7 minutes), hospital stay (9.9 days), and complication rates (25%) were significantly increased for the open group.

Conclusions: For a symptomatic renal cysts, laparoscopic marsupialization is an effective therapy, with a high success rate. If the cost for repeated treatment and higher rate of recurrence of percutaneous aspiration and sclerotherapy is brought into account, even considering the limited number of cases and short follow up period, laparoscopic cyst marsupialization can be considered the first line treatment for simple renal cysts.