経皮的腎嚢胞穿刺とエタノール注入

Abstract

24症例26腎嚢胞に対し, 超音波ガイド下に経皮的穿刺吸引療法を施行した。19腎嚢胞には, 再発予防目的で95%エタノール注入を行い, 7腎嚢胞には, 穿刺吸引のみ行った。穿刺後, 超音波検査またはCTによる経過観察を1～64ヵ月(平均21.1ヵ月)行った。1)穿刺吸収のみの症例は嚢胞の増大した例が2例あり, 平均縮小率は28.9%であった。2)エタノール注入例は完全消失7例あり, 平均縮小率は90.9%であった。3)エタノール注入例では, 疼痛や顕微鏡的血尿等の臨床症状が消失, 軽減した例が多かった。4)副作用は重篤なものはなかった

Ultrasound-guided renal cyst puncture was performed on 26 renal cysts in 24 patients. Puncture of the renal cyst was performed with a 6 Fr single J catheter on a 19.5 gauge needle. In 7 cases, only aspiration of the cyst fluid was carried out. In the other cases, renal cysts were instillated with 95% ethanol as a sclerosing agent to prevent recurrence. All cases were followed up by ultrasound or computerized tomographic (CT) scan for 1 to 64 months. The ethanol-instillated renal cysts were more markedly reduced (average reduction rate: 90.9 +/- 14.7%) than the non-instillated cysts (average reduction rate 28.9 +/- 12.6%). After puncture of the renal cyst, pain and microhematuria disappeared in most patients who had received ethanol instillation. Minor complications such as pain and low grade fever were observed in some cases in this series, but not major complication. Thus, ultrasound-guided renal cyst puncture with 95% ethanol instillation is a useful procedure for the treatment of renal cysts.