Effectiveness and safety of greenlight laser in ureteroscopic parapelvic cyst incision: a retrospective analysis.

Abstract

Objective: Different surgical managements for parapelvic cysts may vary in efficacy and safety. Considering the distinct characteristics of greenlight laser, this study aimed to compare three treatments for parapelvic cysts: flexible ureteroscopic internal incision and drainage with greenlight laser, or with holmium laser, and retroperitoneal laparoscopic cyst unroofing. The focus was on evaluating and contrasting the advantages of greenlight versus holmium laser in this context.

Patients and methods: A total of 62 patients with parapelvic cysts who underwent surgical treatment from January 2018 to January 2023 and met the inclusion and exclusion criteria were retrospectively collected. All patients received CT or ultrasound examination, and were diagnosed with parapelvic cysts by radiologists and urologists. Patients were divided into three groups according to treatment: (1) flexible ureteroscopy with greenlight laser internal incision (n = 18), (2) flexible ureteroscopy with holmium laser internal incision (n = 21), and (3) laparoscopic cyst unroofing decompression (n = 23). Outcomes of the 3 groups were analyzed. The safety and effectiveness of the three surgical methods were evaluated by comparing the imaging examination data before and 6 months after the operation.

Results: There were no significant differences in age, gender, side, or size of the cysts among the three groups. Shorter operation time, less intraoperative blood loss, and fewer postoperative complications were observed in flexible ureteroscopic laser endotomy groups, compared to laparoscopic group.

Conclusion: Flexible ureteroscopic laser internal incision demonstrated several advantages over laparoscopic surgery, including shorter operation time and less blood loss. The greenlight laser exhibited obvious advantage of shorter incision time in the treatment of parapelvic cyst, which made it worthy of clinical application. Our findings might provide evidence to the selection of ideal methods for treating parapelvic cysts.