Here is a large hydatid cyst of the kidney and only a small part of the kidney is remaining, which is flattened in the internal upper part of the cyst.
With only this assessment, will you recommend nephrectomy or nephron-sparing surgery.
http://youtu.be/bT-Hi68vz4U
I realy think that the best decision will be nephjrectomy because the redidual renal function of this kidney seems very low and a conservative surgery technically quite risky
Kind regards
I think that its better to do nephrectomy. It is necesary to know before the renal function oft he other kidney
Thank you Guy,
Do you recommend the nephrectomy, because it is a hydatid cyst or because the kidney is almost inexistent?
However, I am concerned with the" nephrectomy part"; as many studies had shown that one kidney is not sufficient, and nephron- sparing surgery is better in the long term, (survival and quality of life) compared to nephrectomy for benign pathologies.
Nephron sparing surgery is now recommended even for renal cancer.
And the patient is young, 36 years, so can we do an effort and preserve the kidney.
Thank you Maria,
urea and creatinine blood level are normal.
this patient had consulted with a few urologists and they all recommended open nephrectomy without opening the cyst, and thus avoiding the risks of retro-peritoneal dissemination.
However, it is a benign disease and we know that when growing the cyst only stretches the renal parenchyma. So, is there a chance that the kidney will return to normal shape after cyst decompression?
I had published a case of a huge simple cyst and the kidney was stretched (but not as this case) and the kidney returned to almost normal after cyst treatment.
Remission of erythrocytosis and hypertension after treatment of a giant renal cyst.Lezrek M, Fassi-Fehri H, Badet L, Marechal JM, Martin X. Urology. 2002 Jul;60(1):164.
http://www.ncbi.nlm.nih.gov/pubmed/12100948
the patient had an endoscopic percutaneous approach. Here is the video of the CT-scan at 6 months. the kidney has returned to almost normal shape but there is a residual cavity.
http://youtu.be/5AbDL4WVADo
http://youtu.be/5AbDL4WVADo
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