Abstract:

Objective      To investigate surgical occasion of laparoscopic cyst decortication (LCD) in patients with autosomal dominant polycystic kidney disease(ADPKD), in accordance with the renal volume. Methods       The renal volume data from 251 consecutive patients with ADPKD who underwent LCD from June 2004 to October 2009 were retrospectively analyzed. All patients were divided into 4 groups according to the renal volume: group A, <500mL, group B, 500-1000mL, group C, 1000-1500mL and group D, >1500mL. ECT was applied to detect bilateral glomerular filtration rate(GFR) to make a comparison before and 6 and 12 months after surgery. Results      No visible changes were found in GFR before and after LCD in groups A and D(P>0.05), while an increase in GFR was found in groups B and C(P<0.01), and the increase in group B was more prominent than in group C(P<0.05). Patients in group B,C and D were relieved backache and abdominal distension after surgery while a remarkable improvement on hypertension was achieved in group D(P<0.01). Conclusions      Among patients with ADPKD undergoing LCD, the most favorable outcome and GFR improvement are found in those with a renal volume ranging from 500 to 1500mL. Surgery is temporarily dismissed for patients with a renal volume <500mL. LCD has a limited impact on recovery of renal function in patients with renal volume>1500mL while a dramatic effect on relief of complications such as abdominal oppression, pains and hypertension.

Key words: Autosomal dominant polycystic kidney disease; Laparoscopy; Decortication; Renal volume