Comparison of the mid-term outcomes of laparoscopic and percutaneous nephroscopic laser unroofing for the treatment of single renal cyst: a single-center retrospective study.

Purpose: Renal cysts are the most common benign disease of the kidneys, and their increasing size cause compression symptoms that require surgical intervention. In this study, we compared the safety, efficacy and prognosis of percutaneous nephroscopic laser unroofing (PNLU) with those of laparoscopic unroofing (LU) for simple renal cysts.

Methods: Data from patients with single renal cysts who underwent PNLU or LU between Jan 2018 and Dec 2023 were collected and followed up thereafter. Baseline characteristics, perioperative events, blood test results and postoperative complications were compared. Recurrence-free survival (RFS) was also compared via survival analysis. Subgroup analyses were conducted in the PNLU group, including the 980 nm laser and Holmium laser groups.

Results: A total of 75 patients were included, 35 of whom underwent PNLU and 40 of whom underwent LU. Compared with LU, PNLU requires only one surgical incision and is a shorter procedure, causes less blood loss, requires fewer urinary catheter days, is known for quicker drainage tube removal, requires a shorter postoperative hospital stay, has lower hospitalization costs, induces a weaker postoperative inflammatory response, and is associated with a lower incidence of abdominal distension. There was no significant difference in RFS between the PNLU and LU groups. In the subgroup analyses of PNLU, no significant differences were observed between the 980 nm laser and Holmium laser groups.

Conclusion: PNLU is safe, effective and cost-effective for single renal cysts and known for a low complication rate, and its mid-term prognosis is similar to that of laparoscopic surgery.