Puncture of a kidney cyst under ultrasound control - 30,000 rubles.
Kidney cysts, according to various sources, occur in every 2-4 adults. It often occurs silently, without symptoms causing concern, and is discovered by chance during ultrasound. There may be one cyst, or polycystic disease may be observed.
One of the treatment methods is puncture of the kidney cyst. This operation is indicated in cases where the patient has a single cyst, the size of which does not exceed 5 mm in diameter.
When is the puncture performed?
Puncture kidney cysts- This is a puncture of the formation with subsequent pumping out of its liquid contents. For accuracy, ultrasound equipment is used, which allows you to monitor the process of needle insertion.
The puncture itself without sclerotherapy gives only temporary results. Epithelial layer the inner surface of the cyst remains unchanged and continues to live its own life. Over time, the cyst cavity fills with secretion again, which leads to the need to repeat the procedure. Sclerosis of the cyst cavity involves the introduction of substances that promote tissue damage and scarring.
99% ethanol is used as a sclerosing drug, sometimes in combination with antibiotics or antiseptics. After the contents of the cyst are evacuated, substances are introduced into the cavity in a volume equal to a quarter of the secretion removed from the cyst.
How is puncture of a kidney cyst performed?
The manipulation is a minimally invasive operation.
- The patient lies on his healthy side or back. The doctor administers local anesthesia.
- Under the control of an ultrasound machine, the doctor inserts a needle into the cavity of the cyst and sucks out its contents. The cystic secretion is light yellow in color.
- The sclerosing fluid is introduced through the same needle.
- After some time (about 1.5-2 hours), these substances are sucked out. The longer ethanol is in contact with the epithelium of the cyst, the lower the likelihood of relapse.
Puncture at the Medic clinic
Our center has everything you need to delicately and correctly perform a puncture. Experienced doctors, modern equipment, comfortable conditions for the procedure - all this will ensure a high result and allow you to forget about the cyst forever.
| Operations | Price |
|---|---|
| Trocar epicystostomy | 12000 rub. |
| Replacing cystostomy drainage | 3000 rub. |
| Surgery for hydrocele of the testicular membranes: Winkelmann | 20,000 rub. |
| Surgical treatment of dermoid cyst | 8000 rub. |
| Surgery to remove testicular cyst, epididymis, spermatic cord | 25,000 rub. |
| Circumcision of the foreskin | from 15,000 rub. |
| Surgery for varicocele (Marmara operation) | from 30,000 rub. |
| Plastic surgery of the frenulum of the penis, category 1 of complexity | 8000 rub. |
Kidney puncture is a research method in which a small piece of its tissue (parenchyma) is taken from a person for examination.
The puncture is used to treat cysts and also allows accurate diagnosis, as well as monitor the effectiveness of therapy for the following pathologies:
- pyelonephritis (bacterial one- or two-sided kidney damage);
- glomerulonephritis ( autoimmune disease, affecting both kidneys);
- distinguish primary cancer from secondary cancer caused by metastases, as well as benign from malignant tumors;
- chronic renal failure of unknown origin, which is expressed in general weakness, sleep disturbance, persistent increase in arterial metabolism, disturbance electrolyte metabolism, lack of hemoglobin in the blood, specific changes in urine analysis;
- degree of organ damage systemic diseases, such as amyloidosis (a disorder of protein metabolism, accompanied by the deposition of amyloids - specific protein compounds) in tissues), systemic lupus erythematosus ( autoimmune disease connective tissue), diabetes mellitus ( endocrine pathology, in which the level of glucose in the body increases), etc.;
- differential diagnosis of diseases that give similar symptoms, but their therapy is fundamentally different;
- control of function, operation and possible pathology during kidney transplantation, which may be caused for various reasons, including strong drug therapy with immunosuppressants, antibacterial and anti-inflammatory drugs, immune rejection of the transplanted organ.
Technique of the procedure
It is necessary to distinguish between the concepts of puncture and biopsy. A biopsy is performed during abdominal surgery when the kidney is completely open.
Puncture is carried out using a special puncture needle, which is inserted into the parenchyma through a puncture in the skin.
Puncture (or percutaneous biopsy) has become widespread since it is a relatively simple and non-traumatic method of examination.
Manipulation is carried out only in a hospital setting under local anesthesia under ultrasound or x-ray control.
Before the actual puncture, blood and urine tests are taken.
They also do an ultrasound of the kidneys and x-rays of all abdominal organs, immunological studies, Dopplerography of the kidney vessels, and sometimes computed tomography or magnetic resonance imaging.
In addition, studies are being conducted to identify bleeding disorders and allergic reactions to the drug that will be used for local anesthesia.
It is advisable to refrain from eating 8 hours before the puncture, and a light sedative is usually given an hour and a half before the puncture.
When performing a puncture, the patient is placed on his stomach; it is better to place a cushion under him in the lumbar region.
A small incision is made in the area of the diseased kidney, you are asked to hold your breath to exclude the possibility of its displacement due to respiratory movements, and a special puncture needle is inserted.
It consists of two sections: inside the outer cylinder with a cutting edge there is a rod with a notch, where a small part of the cortical and medullary layers of the parenchyma falls.
Then the needle and its contents are immediately sent for laboratory morphological examination, since a delay may lead to incorrect examination results.
Causes and treatment of cystosis
Puncture of a kidney cyst deserves special attention.
This is a small benign formation on the surface of an organ, filled with exudate, which can form after suffering a long-term infectious inflammatory disease urinary system, due to injury, hypothermia.
The cyst can reach several centimeters in size.
Most often, the formation of a cyst occurs without symptoms, and it is diagnosed accidentally during a preventive ultrasound examination or during diagnosis concomitant diseases.
A cyst can produce certain symptoms when it increases to such a size that physical compression of the kidney and ureters occurs.
In such cases there is It's a dull pain, which is localized according to the location of the cyst - on the right or left.
IN in this case The puncture is not carried out for diagnostic purposes, but is a method of treating this disease.
Preparation for this procedure is the same as described above, but the needle itself is not inserted into the organ tissue, but into the cyst, and the contents are sucked out.
Then a special contrast is injected into its cavity, and an ultrasound scan is performed to determine whether the cyst communicates with the internal parts of the kidney - the calyces and pelvis.
If this is not observed, then in order to avoid its re-formation, instead of the removed exudate, ethanol is injected there for some time (up to 20 minutes) in combination with antibacterial and antiseptic drugs.
After the manipulation, the patient needs to remain in a supine position for about 12 hours, while doctors constantly monitor his condition.
Also, physical activity is contraindicated for several days after the puncture.
Contraindications
The main contraindications to puncture are:
- diseases in which there is a high risk of massive bleeding or kidney rupture;
Complications
Most often, after a puncture, a small hematoma forms under the capsule inside the kidney at the injection site, which does not pose any danger and resolves on its own.
There may also be blood in the urine (hematuria) for several days.
Due to blockage of the ureter by a blood clot, renal colic can occur. To prevent this, drinking plenty of fluids is recommended.
There is also a risk of more serious complications, such as subcapsular bleeding, kidney rupture, but since kidney puncture is currently performed under ultrasound guidance, their likelihood is practically reduced to zero.
Source: promoipochki.ru
Technique for puncturing a kidney cyst
Percutaneous puncture of a kidney cyst is performed under local anesthesia in full compliance with the rules of asepsis and antiseptics. Kidney puncture can be performed in outpatient setting under the control of an ultrasound machine.
Simple renal cyst
Simple cysts are asymptomatic in most cases. Only a small number of patients experience pain in the lumbar region, increased blood pressure and urinary disorders. Such symptoms are explained by the large size of the cavity and specific location.
This disease is diagnosed using ultrasound examination or computed tomography.
There are several treatment methods: biopsy, cyst resection or nephrectomy. IN Lately they try to carry out organ-saving operations, especially if it is possible to limit oneself to performing a therapeutic and diagnostic puncture.
Indications for puncture of a kidney cyst
Simple cysts do not require special treatment, especially if they do not cause productive symptoms. However, there are several indications for percutaneous puncture of a kidney cyst.
With pronounced pain syndrome or increased blood pressure, the cyst must be removed. Also, puncture of a kidney cyst is carried out when the outflow of urine is impaired, or in the case when a benign formation reaches a very high level. large sizes and may threaten the patient's life.
Puncture technique
The purpose of percutaneous puncture of a kidney cyst is to puncture the wall of the formation cavity, evacuate fluid and introduce a sclerosing agent. The position of the patient on the operating table depends on the location of the formation. If it is in the upper, middle, lower segments on the lateral surface, then the patient must be placed on his stomach. But in cases where the cyst is localized on the medial surface of the kidney, the patient should lie on the other side.
The procedure for percutaneous puncture of a kidney cyst is carried out under ultrasound guidance. Before performing a puncture, the doctor must determine the needle entry point and the angle of inclination. Do not damage the kidney tissue itself or pass the needle through the collecting system. Undoubtedly, during the procedure, large vessels or nearby organs cannot be damaged. Also, using ultrasound, the depth of insertion of the puncture needle is determined. A special clamp is placed on it, which does not allow the doctor to enter deeper than necessary. This tactic helps to avoid adverse consequences.
After anesthesia, the surgeon uses a scalpel to make a small incision in the skin, and uses a mosquito clamp to separate the layers of skin and subcutaneous fat. This technique was chosen for easier tissue restoration and shortening the rehabilitation period.
The puncture itself is performed with a special needle, which is equipped with an echo-positive tip (that is, it is visible on the screen when ultrasound diagnostics). Since the entire procedure is performed under the control of an ultrasound machine, this tip provides maximum accuracy.
- The cavity is filled with sclerosant. The volume of injected liquid is 20-25% of the original volume. This is done in cases where the intracystic fluid is serous in nature without the presence of pus. By administering a sclerosant, doctors prevent the re-formation of the cyst.
- If the cyst was filled with pus, then it is necessary to install a drainage, completely sanitize the cavity, and then (after 4-5 days) inject a sclerosing substance. The Seldinger technique is used to install drainage.
Possible complications
The technique for percutaneous puncture of a kidney cyst is simple. But despite this, it is possible that undesirable consequences. If medium or large vessels are damaged, bleeding into the cyst cavity or perinephric tissue is possible. The amount of blood loss depends on the size of the damaged vessel.
If the rules of asepsis and antisepsis are not followed, purulent-inflammatory processes may develop. In rare cases, the patient develops pyelonephritis. The patient may also develop allergic reaction for anesthetic drugs or sclerosants.
Postoperative follow-up
After the operation, the patient is discharged home on the third day, unless complications arise. It should go away in two weeks ultrasound examination. The doctor observes the dynamics and condition of the remaining formation. If fluid continues to accumulate in the cavity, the patient should be monitored for another 2 months. A repeat procedure is prescribed if positive dynamics are not observed for more than 6 months.
The advantages of percutaneous puncture of a kidney cyst are its painlessness and low invasiveness. Relapses are extremely rare and can be explained individual characteristics body.
Source: pochkimed.ru
Renal cyst puncture
Typically, a kidney cyst does not require medical intervention, but if necessary, it can be removed using a puncture. The procedure is safe, painless, with the least risk of complications. Before deciding to puncture a kidney cyst, take into account the individual characteristics of the person, because there are contraindications to it.
The danger of kidney cysts
The danger of a kidney cyst is as follows:
- Appearance pain, discomfort and heaviness. Symptoms occur infrequently;
- Hypertension. The entire volume of blood passes through the kidney within three to four minutes. If the blood supply decreases, it begins to produce renin, which leads to renal hypertension;
- Kidney cyst cancer is the most terrible complication. The lining of the cyst consists of constantly dividing epithelial cells. With pathologies in the division control mechanisms, this kidney disease can form.
Types of pathology
The kidney is a system of tubes. If one of them is blocked due to an inflammatory process, then over the course of several years fluid is produced at a slow pace, the cavity enlarges, squeezing one kidney and disrupting its function - this is how a cyst forms.
Simple cysts usually occur without characteristic symptoms. Sometimes there is lower back pain, hypertension and problems with urination. This indicates that the cyst has become such a size that it is impossible not to feel it and is located in a specific place.
Types of operations
Removal of a cyst occurs during an open operation, accompanied by excision of a part or organ completely. Recently, such measures have been rarely resorted to.
With minimally invasive methods, the cyst is not completely removed. During surgery, the walls of the cyst are glued together or sutured to the edges of the wound.
Classification by access method:
- Retrograde operations. Consists of inserting an endoscope into the urethra;
- Percutaneous operations. Puncture in the back or stomach.
The therapeutic method is chosen after ultrasound and other tests. Sometimes patients go to different clinics because doctors have different opinions.
Indications for puncture
The problem is usually noticed during a general medical examination. The procedure is resorted to when the following symptoms are observed:
- Finding blood in the urine;
- Long-term hypertension that does not go away after drug treatment;
- Volumetric formation in the lumbar region;
- Sharp dull pain in the lower back or hypochondrium, renal colic. The problem is especially noticeable after physical activity.
Contraindications
The procedure is not safe for everyone and contraindications to it may include the following:
- Exacerbation diabetes mellitus;
- Pathologies of the respiratory or of cardio-vascular system;
- No noticeable symptoms of a kidney cyst;
- Active inflammatory process;
- Allergic reactions.
Even with herpes or a runny nose, it is worth rescheduling the puncture and waiting for remission.
Diagnosis of the problem
To detect the problem and determine its severity, use following methods diagnostics:
- X-ray allows you to see the size of the kidney, displacement of the ureter, contour, changes in the pelvis and calyces;
- Ultrasound examination helps to identify the cyst. The cyst is a ball-shaped formation with clear contours. With the help of research, changes in dynamics can be observed;
- CT scan helps to identify pathologies in the functioning and functioning of the kidneys, distinguishes a cyst from cancer. After the CT scan, the doctor can choose the right treatment;
- Doppler ultrasound provides information about the blood supply to the kidney;
- A biochemical study identifies the cause and checks the functionality of the kidney.
The essence of the puncture
A specialist, under ultrasound control, makes a puncture, inserts a special puncture needle into the tumor and draws out the liquid contents. It is examined to determine the nature of the cyst and exclude the possibility of cancer. The space that remains after removal of the cyst is slowly filled with connective tissue. Puncture of the kidney cyst has the following advantages:
- High speed carrying out the procedure;
- Lowest risk of complications;
- Low cost;
- The method is minimally invasive and effective.
To prevent the cyst from appearing again, after percutaneous puncture of the kidney cyst, a sclerosing agent is injected. This promotes gluing of the walls and does not release fluid that fills the cyst, which eliminates the possibility of relapse. The disadvantages of the procedure include the risk of infection in the kidney.
It is necessary to distinguish between conventional puncture and puncture kidney biopsy. A biopsy is performed for the purpose of diagnosis, selection of treatment and monitoring of the donor kidney. The method is similar to puncture, only a small piece of tissue is taken.
Preparation for the procedure
It is recommended to exclude baked goods, vegetables and fruits from the diet. Before the operation, it is better to abstain from evening meals and cleanse with an enema. The last meal and drinks should be eight hours before surgery.
It is necessary to cut off the hair from the abdomen and pubic area. You should not shave them off, as the follicles may become inflamed. Rinse the navel thoroughly and remove any piercings. If you have varicose veins, you should take it with you compression hosiery and put it on during puncture. Sometimes the doctor recommends wearing it after surgery.
Technique
Puncture of a kidney cyst is carried out after research and determination of the properties of the cyst. Depending on the location of the cyst, the patient is positioned on the stomach or side. The puncture area is disinfected with antiseptics and injected with painkillers. The injection needle is equipped with a special tip, visible on the screen of the ultrasound machine for the purpose of greatest accuracy.
Based on the results of diagnosing a kidney cyst, the localization of the puncture and its depth are determined so as not to affect large blood vessels and the kidney parenchyma. The maximum permissible depth is marked on the needle to prevent complications. Afterwards, the doctor makes a small incision, the tissues are pulled apart and secured with a clamp. With the help of a puncture with a needle, the liquid contents flow out.
Sclerosant
If there is no inflammatory process or the appearance of pus, after removal of the cyst it is necessary to administer sclerosing substances. Usually this ethanol. Its volume is 1/4 of the volume of the extracted liquid contents. Depending on the characteristics of the pathology, the substance remains in the cavity from five to twenty minutes, after which it is removed. Because of this, the cells that secrete fluid die, which leads to the cavity sticking together. The patient feels during this burning pain.
Sometimes, when removed, blood or pus is noticed in the fluid. This usually happens if the cyst appears due to injury. Then, after the operation, a drainage is installed, and the cystic cavity is sanitized and washed. Drainage remains for three to five days until the inflammatory process disappears. The procedure is carried out four times, leaving the sclerosing agent on for two to three hours. Afterwards the drainage is removed.
Other methods
In addition to puncture, other methods are used to treat kidney cysts:
- Laparoscopic cystectomy is the name of surgery for a kidney cyst, which is also a minimally invasive method. The puncture is done near the navel. Gas is pumped through the port into abdominal cavity to create space for manipulation. The location of the other two punctures depends on the clinical picture. Using the inserted instruments, the cyst is separated from the tissue;
- Retrograde operation. The procedure is carried out under general anesthesia. An endoscope is inserted through the urethra. The instrument is brought to the kidney to excise the formation. The walls are sutured to adjacent tissues;
- Open surgery. It is resorted to when there is extensive tissue damage and the malignancy of the neoplasm is proven. Only 5% of operations are performed using this method.
Possible complications
Despite the simplicity of the operation, consequences and possible complications cannot be excluded. In rare cases, large and medium-sized vessels are damaged, which causes bleeding into the tumor cavity or perinephric tissue. Depending on the size of the damaged vessel, the volume of blood lost varies.
If antiseptic rules are neglected, purulent-inflammatory processes develop. Sometimes pyelonephritis or an allergy to anesthetics or sclerosants may occur.
Rehabilitation period
If there are no complications, discharge from the hospital occurs after two to three days. After 14 days, a control ultrasound examination is prescribed. Using this method, the scarring process and the chance of relapse are assessed. If the fluid starts to come out again, wait about two months. If the process lasts more than six months, a repeat operation is performed. Relapse occurs infrequently, depending on individual characteristics. This depends on the location of the formation, its structure, uneven wall thickness or sclerosis, inflammation.
Cost of puncture
Diagnostic tests and the puncture itself can be done free of charge in public clinics By insurance policy. The main thing is that the hospital has the necessary equipment.
If desired, puncture aspiration of a renal cyst can be done for a fee. The price will vary from 3 to 100 thousand rubles. The sclerotherapy procedure will add 10 to 20 percent to the total cost.
The diameter of a kidney cyst is usually 4.5-8.3 cm. The volume of fluid is 20-240 ml. Usually the puncture is well tolerated. The advantages of the procedure are its low invasiveness and painlessness. The cyst rarely appears again and is explained by individual characteristics.
Source: kistayaichnika.ru
Renal cyst puncture: indications and contraindications, procedure technique
In most cases cystic formations are benign in nature. The danger arises when the size of the neoplasm increases and compression of nearby tissues occurs, disrupting the functioning of the affected organ. Large formations must be removed.
The most common and effective method the fight against neoplasms is puncture.
Puncture of a kidney cyst is method surgical treatment, which allows you to safely and painlessly eliminate the tumor and obtain material for testing for the presence of cancer cells.
The procedure is performed by a surgeon in a hospital under ultrasound control. The essence of the operation is to pump out intracystic fluid through a puncture of the skin using a special needle.
Indications for puncture of a kidney cyst
Small formations (up to 5 cm) do not require intervention, which do not disrupt kidney function and do not have negative influence for the work of the whole organism.
Cyst removal is indicated if:
- The pathology causes painful sensations - dull or cutting pain in the back, hypochondrium, renal colic;
- Increased performance Blood pressure that cannot be normalized long time;
- Development of pathologies genitourinary system– impurities of blood and pus in the urine, difficult painful urination;
- The size of the neoplasm reaches 5 cm or more;
- The beginning of the process of transformation of the neoplasm into malignant tumor.
Puncturing has many advantages:
- Minimal trauma to organs and tissues, since one puncture with a special needle is enough for the procedure,
- The speed of the operation is 30 minutes;
- High precision of execution - manipulations are carried out under ultrasound control;
- Minimal likelihood of complications.
To prevent recurrent cyst formation, sclerosis of the kidney cyst is performed.
The procedure consists of introducing a sclerosing agent (ethyl alcohol) into the neoplasm freed from fluid. As a result, the walls of the capsule stick together, the cells die, and the production of intracystic fluid stops. In the future, the tumor does not progress and does not pose a threat of degeneration into a malignant tumor.
Contraindications for kidney cyst puncture
Performing puncture of a kidney cyst under ultrasound control is the most modern and precise method treatment of patients, as it allows you to perform the procedure efficiently and prevent serious mistakes - damage to the kidneys, blood vessels and neighboring tissues.
Ultrasound of the kidneys allows us to identify a number of contraindications:
- Extensive multi-chamber formations. It is necessary to remove fluid and sclerotherapy in each part of the tumor, which is difficult to accomplish with this method;
- Thickening of the capsule due to the accumulation of calcium, in the form of salt deposition (calcinosis), as a result, the walls of the neoplasm do not “stick together” and the procedure is useless;
- Difficulty in percutaneous access due to the localization of the tumor in the renal pelvis or in the sinus area;
- Communication of the formation with the intrarenal system makes the sclerotherapy procedure impossible, due to the risk of damage to the entire organ;
- The size of the formation is from 7-8 cm, increases the likelihood of relapse of the disease.
A kidney cyst in newborn babies or older children is diagnosed in the same way, using ultrasound diagnostics. Treatment methods are the same as for adults, aimed at stopping growth and removing formations - drug therapy, puncturing, operation. Contraindications are the same for everyone.
Preparing for surgery
In preparation for surgery, based on the patient’s diagnostic results, the exact size and location of the tumor are determined. To prevent injury to the kidney, neighboring organs and tissues during the procedure, the depth of insertion of the needle is determined by measuring the distance from the skin to the center of the tumor using ultrasound.
The required distance is marked on the needle and a limiter is placed, which will allow you to control the insertion depth.
Depending on the location of the tumor, the position of the patient during surgery varies. If the formation is located on the posterior surface of the kidney, then the patient is in horizontal position lying on your stomach.
If it is necessary to puncture a cyst of the left kidney located on the anterior wall, the patient should be lying down on the right side. And, conversely, when puncturing a cyst right kidney, patient position, lying on the left side.
Puncture takes place under local anesthesia and ultrasound guidance.
Technique for puncturing a kidney cyst
After completing the preparation, puncture of the cyst on the kidney is performed. The puncture site is being processed antiseptics, and painkillers are administered. An incision is made in the skin, the tissues are pulled apart and fixed. The puncture is performed with a needle with a tip that is clearly visualized on the monitor of the ultrasound machine; for maximum accuracy, intracapsular fluid is pumped out.
This technique provides more easy recovery and healing of damaged tissues and reduces the rehabilitation period.
After puncture of the kidney formation, the fluid is sent to medical research(cytology and biochemical analysis) to determine the reasons that caused the formation and exclude the presence of cancer cells.
Puncture of a kidney tumor, after removing fluid from the formation, can provoke an inflammatory or purulent process. If this does not happen, a sclerosing agent (ethyl alcohol) is poured into the vacated cavity for a short time, approximately 5 to 20 minutes, depending on the complexity of the situation.
After the required time has passed, the substance is removed, the walls of the capsule are glued together.
If pus or blood is detected in the liquid contents, the cavity is washed and drainage is placed for 3-5 days until the inflammatory process ends. Next, sclerotherapy is carried out at least 4 times, leaving the substance in the cavity for several hours, and the drainage is removed.
Possible complications
Puncture of a renal tumor is a minor operation that is performed on an outpatient basis in accordance with the necessary rules and requirements of surgical intervention. After the procedure, the patient remains in the hospital for several days under the supervision of doctors to prevent deterioration of the condition and the development of unexpected exacerbations. Puncture, like any surgical intervention, has a risk of complications.
The following are distinguished: dangerous consequences:
- Hemorrhage into the kidney cavity or neoplasm;
- Development of an inflammatory, purulent process;
- Allergic reaction to a sclerosing agent;
- Pyelonephritis;
- Damage to the kidney and damage to neighboring organs.
For polycystic disease or a tumor larger than 7 cm, the procedure is not very effective.
Rehabilitation period
Any operation, even the most minor one, is accompanied by a violation of tissue integrity and interference with work internal organs. The recovery period after surgery can last about a month, depending on the characteristics of the body. Rehabilitation after puncture requires less time than other types of surgical intervention.
Within a few days after the procedure, the patient is discharged from the hospital. After 2 weeks, he is recommended to undergo an ultrasound examination in order to monitor the process of tissue healing and re-cyst formation.
At the early stage of recovery after puncture, there may be an increase in body temperature and pain in the puncture area on the abdomen. To remove discomfort painkillers are prescribed. In some cases, patients experience weakness, nausea, and bloating. After a few days, the symptoms go away on their own.
IN recovery period The patient is advised to avoid any physical activity, maintain bed rest and proper nutrition. The diet should contain mainly easily digestible foods: low-fat kefir, crackers, soups, broths, boiled meat and fish.
Recurrent development of pathology is extremely rare and depends on the individual characteristics of each person’s body.
Source: prorak.info
Features of kidney cyst puncture
A kidney cyst is a cavity in the parenchyma of a paired organ filled with fluid. The pathology is benign. Cyst puncture is the main method of surgical treatment. In the process, the liquid contents are removed from the tumor and relapses are prevented.
What is a kidney puncture?
The procedure is carried out under ultrasound control. The specialist pierces skin covering over the organ being examined, after which a needle is inserted into the neoplasm, pumping out the liquid contents. The resulting secretion is examined to determine the nature of the neoplasm and exclude the possibility of cancerous tumor. The puncture formed after puncture of the cyst heals over time.
The surgical method has a number positive aspects:
- Low degree of invasiveness.
- High efficiency.
- Kidney puncture does not take much time.
- Low cost of the procedure.
- Low likelihood of complications after surgery.
However, puncture of a kidney cyst has one drawback - high risk recurrence of the tumor. To reduce the risk of relapse, after removing the liquid contents, a sclerosing-type substance is injected into the cavity. In most cases it is alcohol. The substance glues the structure of the cyst from the inside, which prevents the release of fluid filling the cyst. Thus, kidney puncture is not accompanied by re-formation of the tumor.
Another disadvantage is the high risk of infection of the operated organ.
How is it carried out?
The procedure is performed using local anesthesia. A urologist, an ultrasound specialist and a nurse must be present during the operation. The position of the patient on the table depends on the location of the tumor and its size. If the tumor is not on the kidney, but on the side of it, the patient needs to lie on his side.
Initially, the doctor determines the puncture site, and an ultrasound machine identifies nearby organs and vessels so as not to cause damage during the puncture process. The depth of the puncture is determined, and a limiter is installed on the needle.
A small incision is made with a scalpel and the skin is pulled apart, after which a needle is inserted and the liquid contents of the neoplasm are collected. The resulting secretion is sent for analysis. After all the fluid has been removed, a sclerosing agent is injected into the cavity.
If the neoplasm is purulent, the doctor installs a drainage and sanitizes the tumor cavity. The sclerosing drug is administered after 4 days. The Seldinger technique is used to install drainage.
After the procedure, the patient is prescribed a course medicines antibacterial in nature.
Indications for surgery
Most patients have no clinical signs of a cyst. Pathology is most often diagnosed during a preventive medical examination. However, some patients experience some symptoms:
- Urine contains impurities of blood cells.
- A person has constantly high blood pressure, and taking medications does not help.
- In the lumbar region, palpation can detect swelling.
- Painful sensations sharp in the lumbar region, which intensifies after physical exertion.
- The cyst began to degenerate into a malignant tumor.
Important! If you have one of the above symptoms, it is strongly recommended to consult a specialist for advice.
Possible complications
Puncture of a kidney cyst is performed on an outpatient basis; after surgical treatment, the patient requires observation in medical institution for 3 days. In most cases, after surgery, the patient recovers quickly and makes a full recovery.
Some patients complain of fever or slight swelling in the puncture area; the above-described complications quickly disappear without additional treatment. Serious mistakes can be avoided by using an ultrasound machine.
In some cases there are the following complications:
- Bleeding into the cavity of a neoplasm or affected organ.
- The onset of an inflammatory process is possible in the event of an infectious lesion of the organ.
- Clinical signs allergic reaction to sclerosing liquid.
- Provoking pyelonephritis and other pathologies of the renal system.
- Damage to the kidney or other internal organs.
Important! For large tumors (more than 70 millimeters), the procedure is characterized by a low degree of effectiveness.
Contraindications to the procedure
Surgical treatment of a tumor in the kidney using the puncture method has contraindications:
- A large number of cystic formations or a multi-chamber tumor. To achieve the desired effect, it is necessary to sclerose each compartment, which is problematic to do using the puncture method.
- The tumor is located in the sinus area, which complicates access through the skin.
- The cyst communicates with the internal kidney system. Sclerosis is impossible due to the risk of damaging the tissue of the entire organ.
If there is a contraindication, other therapeutic methods are used to remove the tumor.
Rehabilitation
If the patient has no complications after the procedure, he is discharged from the hospital after 3 days. After 1.5-2 weeks, an ultrasound examination of the operated organ is performed, the doctor pays attention to scarring of the kidney, possible relapses.
If fluid is released after surgery, the doctor adheres to a wait-and-see approach for 8 weeks. If the process of accumulation of cystic fluid continues for more than 6 months, repeat puncture is performed. The likelihood of relapse is extremely low.
As is known, according to statistical studies, every fourth person over the age of 42 years is found to have one or even several kidney cysts, the size of which exceeds 10 mm. Moreover, the frequency of detection of this disease increases the older the person is; at least eight out of a hundred people with this pathology require serious treatment.
Need for different types medical manipulations occurs only when the patient has complaints:
- for pain or discomfort in the projection of the kidney;
- changes in urine patterns or problems with urination;
- to increase blood pressure.
Also a reason to take a kidney cyst seriously is the large size of the cyst (50 mm or more) and the presence of other diseases of this organ, for example, pyelonephritis or urolithiasis disease. If there are no above-mentioned complaints, and the kidney cyst itself does not exceed 50 mm, then such a patient is recommended to periodically undergo an ultrasound examination of the kidneys once or twice a year in order to monitor the growth or stability of the size of the space-occupying formation.
Today, for diagnostic and treatment purposes, the most successful minimally invasive technique is percutaneous kidney puncture. In some cases, if indicated, laparoscopic surgery or open access can be performed.
What is puncture of a kidney cyst?
Puncture of a kidney cyst is a medical procedure that involves puncturing the formation, sucking out the liquid contents from it, which is then sent for examination, and often introducing a sclerosant. This procedure is performed using a special needle under the control of ultrasound or X-ray visualization of the organ.
It is important! Puncture of a kidney cyst with suction of its contents in more than half of the cases soon led to its reappearance. Since this was only part of the solution to the problem: the contents were removed, but the walls lined with fluid-secreting cells remained, which caused the development of relapses. On this moment The problem of refilling a once-drained cyst disappeared thanks to the use of the cavity sclerosis method.
Sclerosis of the cavity during kidney puncture is carried out by introducing pure ethanol (96%) in an amount equal to approximately a quarter of the volume of the extracted liquid, a combination of alcohol with antibiotics or antiseptics is also used, after 7-15 minutes the drug is sucked out of the cyst.
It is important! Some experts recommend longer exposure times for sclerosant (up to 2 hours). Also, according to studies by a number of authors, repeated kidney puncture after 12 hours with the introduction of ethanol or another sclerosing substance gives a much more pronounced effect and reduces the likelihood of cyst recurrence.
How is a kidney puncture performed?
The procedure for puncturing a kidney cyst is performed under local anesthesia and generally takes a little more than half an hour. The patient is asked to lie down on his healthy side or stomach, the future puncture site is treated with an antiseptic and injected with an anesthetic drug. A special puncture needle pierces the skin and underlying tissues, and then, under the control of an ultrasound machine (X-ray unit), it is inserted into the cyst and the contents of the cavity are extracted through it. Typically, the fluid obtained during kidney puncture has a straw-yellow hue, but if the cyst has degenerated into a malignant tumor, the puncture may have a reddish or even brown color. 
Part of the resulting liquid is sent for cytological and biochemical studies. After the contents of the cyst are evacuated, its walls collapse, and a cyst is inserted into the cavity to check whether it communicates with the calyces or pelvis of the kidney. In the case when the cavity is isolated from others renal structures, sclerosing medications are administered.
Contraindications for puncture
In some cases, kidney puncture cannot be performed due to contraindications:
- Multiple or multilocular cysts - to achieve positive result from a kidney puncture it is necessary to remove the contents and sclerosis all cysts or all chambers of one formation, but with such a course of this renal pathology the procedure is difficult to perform in the required volume;
- Calcification or sclerosis of the cyst wall - due to the compaction of the cystic membrane after removal of the fluid, it does not collapse, so puncture in this case is not effective;
- Parapelvic location of the cyst - with such localization of the formation, percutaneous access to it is difficult;
- A cyst communicating with the abdominal cavity system of the kidney - the introduction of sclerosing substances is impossible, due to the fact that they will spread throughout the abdominal system, damaging it;
- Its diameter exceeds 75-80 mm - with such dimensions the probability of its recurrence after puncture is very high.
It is important! The larger the cyst, the less effective sclerotherapy is. This statement applies to formations whose diameter has exceeded 7 centimeters.
In these cases, puncture with the introduction of ethanol may be ineffective or not available due to the localization of the formation, so alternative methods its treatment, such as laparoscopic surgery or removal through an open approach.
Possible consequences of kidney puncture
Renal puncture is a procedure that is performed on an outpatient basis and in most cases does not require inpatient monitoring. Consequences of puncture are rare, since the capabilities of modern ultrasound machines allow us to avoid most possible errors during manipulation, such as damage to large blood vessels and/or the renal collecting system.
Probability of development infectious complications with this procedure is also low, since after the puncture the patient is prescribed a preventive course of antibacterial drugs.
Sometimes patients may notice such consequences of kidney puncture as nausea, fever, the appearance of a hematoma at the puncture site, redness of the urine, but usually all these phenomena are short-lived and do not require specific treatment.
It is important! After puncture and sclerotherapy of the cyst, the likelihood complete cure is 74−100%, but if the procedure was performed twice (the second 12 hours after the first), then this figure reaches 94%.
Includes puncture of the tumor. Next, the liquid contents are collected and sent to medical examination.
This disease often occurs in both men and women over forty years of age. A benign cyst is the most common type of neoplasm, which can reach a size of 10 cm and above.
7 groups of people susceptible to kidney cysts:
- in elderly people;
- at infectious diseases urinary system;
- for hypertension and vegetative-vascular diseases;
- due to kidney injury;
- with urolithiasis;
- in patients with tuberculosis;
- after surgery on the kidneys and the entire urinary system.
At the moment, medicine does not stand still. A method of percutaneous kidney puncture was developed. But sometimes, if indicated, specialists are able to perform laparoscopic intervention or open access surgery.
Diagnostics
This procedure is performed using a specialized needle under ultrasound control or X-ray visualization of the organ.
Note. Interventions such as puncture of the kidney cyst led to reappearance over time. After removing the liquid formation, the cells forming the contents remained, which caused a relapse.
Modern medicine has decided this task single drainage of a kidney cyst, namely by sclerosis of the cavity.
This method is carried out by adding 96% ethanol, which makes up ¼ of the volume of the extracted liquid, and after 7-15 minutes the product is removed from the soil cyst.
Puncture technique
The operation lasts about 30 minutes. It is performed under local anesthetic. then the intervention site is disinfected with an antiseptic solution and an anesthetic is administered. Using a puncture needle, the doctor makes a puncture through the skin and tissue, then, under the strict supervision of an ultrasound machine or x-ray, inserts the kidney into the cyst. Once successful penetration of the tumor has been achieved, the doctor will remove the liquid cyst formation.
Contents after puncture benign tumor has a shade from straw to yellow, and the cyst has turned into malignant stage, then the liquid has a red or brown tint.
The extracted liquid formation is sent for medical examination: cytology and biochemical analysis. Specialists check the contents for the connection between the cyst and the calyces and renal pelvis. If the cavity is completely isolated, then sclerosing medications are administered.
The cause of cystosis and its treatment
Kidney cysts is one of the most common diseases. Most often, this disease was found in the adult population.
Cysts occur when the collection tubes in the kidney become clogged, but the fast growth filter elements.
Typically, kidney cysts have a positive appearance for a long time. A person may not notice them until he undergoes a medical examination.
Most often, kidney cysts are accompanied by increased arterial hypertension, the occurrence of an inflammatory process in the kidneys, namely pyelonephritis.
Surgery is resorted to only if the size of the tumor is at least 5 cm.
Urgent surgical intervention includes:
- suppuration of the tumor;
- severe and prolonged pain;
- strangulation of the ureter and pelvis;
- Arterial hypertension does not stop.
Kidney biopsy as one of the diagnostic methods
Biopsy is a modern medical procedure that is widely used throughout the world.
This medical study is carried out with the collection of a small piece of kidney tissue with cortical and cerebral fluid for further examination under a microscope.
Attention. Biopsy is one of the most difficult surgical interventions. Such operations are carried out strictly in hospitals with a nephrology department. This operation has both indications and contraindications.
There are two types of such examination of kidney cysts: percutaneous and open access.
Percutaneous biopsy is the most popular diagnostic method. It is used to collect biological material using a special needle that passes through the skin and tissue.
The surgical biopsy method is performed under general anesthesia. During medical intervention the necessary tissue is taken for a morphological study. This operation is indicated for a patient with bleeding problems or with one kidney.
This examination gives accurate forecast in the development of the disease, makes it possible to choose correct treatment, helps control the disease while prescribing medications.
Methodology
Specialists place the patient on the operating table depending on the location of the tumor.
The entire kidney puncture operation is carried out strictly under ultrasound supervision. Before inserting the needle, the doctor determines the puncture site and its angle. The device also allows for the depth of the puncture.
A specialized needle has a fixing tip that will prevent you from plunging deeper into the cyst than necessary. This procedure will help you avoid unpleasant moments.
Once the patient has been given anesthesia, the specialist will make a small incision on the patient’s skin, then use a clamp to spread apart the skin tissue and subcutaneous fat. This procedure allows short time restore skin tissue and shorten the rehabilitation period.
After penetration into the cyst, the wire aspirates the liquid contents.
If during puncture the cyst cavity is filled with pus, then drainage is installed and the cavity is completely sanitized. Then, a week later, sclerosing fluid is injected.
When the cyst cavity is absolutely clean, it is filled with sclerosant. Typically this is a volume of 20 to 25% of the initial volume.
During and after surgery, complications may occur in the form of bleeding inside the cyst. The amount of blood loss varies.
Experts warn the patient that if antiseptic rules are not followed, an inflammatory process may develop, with the formation of pus.
Simple cyst in the kidney
Such a benign formation can be congenital, acquired, cancer, genetic, or associated with tuberculous sclerosis.
A simple cyst develops from the renal canals, and breaks the connection with other canals of the kidney. The cause of tumor formation is accelerated growth epithelial tissues.
This neoplasm can cause constant pain, stagnation of urine and is the cause of the onset of inflammation. In medicine, there are cases when hemorrhage or an infectious process occurs in a kidney cyst.
Attention. Experts say that sometimes tumor formation is the cause of kidney failure.
Simple cysts can be detected using ultrasound and MRI examinations.
To combat the tumor, specialists can prescribe drug treatment or surgery.
Indications
This medical examination is indicated for a patient who has pain, high blood pressure or impaired urine flow.
Puncture technique
As before any operation, blood and urine tests are taken.
Before surgical intervention the patient is placed on his stomach. Then a small incision is made in the area of the diseased organ and you are asked not to breathe. This will allow the special needle to be inserted without displacement. Inside the needle there is a small rod where the collected biological material is located.
Then the needle with its contents is immediately sent for morphological examination.
Percutaneous puncture of a kidney cyst is performed under local anesthesia in full compliance with the rules of asepsis and antisepsis. Renal puncture can be performed on an outpatient basis under ultrasound guidance.
Simple renal cyst
Simple cysts are asymptomatic in most cases. Only a small number of patients experience pain in the lumbar region, increased blood pressure and urinary problems. Such symptoms are explained by the large size of the cavity and specific location.
This disease is diagnosed using ultrasound or computed tomography.
There are several treatment methods: biopsy, cyst resection or nephrectomy. Recently, attempts have been made to carry out organ-saving operations, especially if it is possible to limit oneself to performing a therapeutic and diagnostic puncture.
Indications for puncture of a kidney cyst
Simple cysts do not require special treatment, especially if they do not cause productive symptoms. However, there are several indications for percutaneous puncture of a kidney cyst.
If there is severe pain or increased blood pressure, the cyst must be removed. Also, puncture of a kidney cyst is carried out when the outflow of urine is impaired, or in the case when a benign formation reaches a very large size and can threaten the patient’s life.
Puncture technique
The purpose of percutaneous puncture of a kidney cyst is to puncture the wall of the formation cavity, evacuate fluid and introduce a sclerosing agent. The position of the patient on the operating table depends on the location of the formation. If it is in the upper, middle, lower segments on the lateral surface, then the patient must be placed on his stomach. But in cases where the cyst is localized on the medial surface of the kidney, the patient should lie on the other side.
The procedure for percutaneous puncture of a kidney cyst is carried out under ultrasound guidance. Before performing a puncture, the doctor must determine the needle entry point and the angle of inclination. Do not damage the kidney tissue itself or pass the needle through the collecting system. Undoubtedly, during the procedure, large vessels or nearby organs cannot be damaged. Also, using ultrasound, the depth of insertion of the puncture needle is determined. A special clamp is placed on it, which does not allow the doctor to enter deeper than necessary. This tactic helps to avoid adverse consequences.
After anesthesia, the surgeon makes a small incision in the skin with a scalpel, and uses a mosquito clamp to push apart the layers of skin and subcutaneous fat. This technique was chosen for easier tissue restoration and shortening the rehabilitation period.
The puncture itself is performed with a special needle, which is equipped with an echo-positive tip (that is, it is visible on the screen during ultrasound diagnostics). Since the entire procedure is performed under the control of an ultrasound machine, this tip provides maximum accuracy.
- The cavity is filled with sclerosant. The volume of injected liquid is 20-25% of the original volume. This is done in cases where the intracystic fluid is serous in nature without the presence of pus. By administering a sclerosant, doctors prevent the re-formation of the cyst.
- If the cyst was filled with pus, then it is necessary to install a drainage, completely sanitize the cavity, and then (after 4-5 days) inject a sclerosing substance. The Seldinger technique is used to install drainage.
Possible complications
The technique for percutaneous puncture of a kidney cyst is simple. But despite this, undesirable consequences may occur. If medium or large vessels are damaged, bleeding into the cyst cavity or perinephric tissue is possible. The amount of blood loss depends on the size of the damaged vessel.
If the rules of asepsis and antisepsis are not followed, purulent-inflammatory processes may develop. In rare cases, the patient develops pyelonephritis. The patient may also develop an allergic reaction to anesthetic drugs or sclerosants.
Postoperative follow-up
After the operation, the patient is discharged home on the third day, unless complications arise. He is scheduled to undergo an ultrasound examination in two weeks. The doctor observes the dynamics and condition of the remaining formation. If fluid continues to accumulate in the cavity, the patient should be monitored for another 2 months. A repeat procedure is prescribed if positive dynamics are not observed for more than 6 months.
The advantages of percutaneous puncture of a kidney cyst are its painlessness and low invasiveness. Relapses are extremely rare and are explained by the individual characteristics of the body.
