Introduction: The purpose of this study was to present our long-term experience of retroperitoneal laparoscopic decortication (RLD) for patients with severely symptomatic simple renal cysts. The feasibility, safety and efficacy of this technique is reported, along with immediate and long-term clinical outcomes. Materials and Methods: Over a 6-year period, 22 consecutive patients with symptomatic simple renal cysts underwent RLD by a single surgeon. Demographic data, perioperative blood loss, length of operative procedure, length of hospital stay and complications were analyzed. Follow-up included clinical review and renal ultrasonography, at 6-monthly intervals for 1 year, and then annually. Results: The mean patient age was 45 (range 31–63) years. RLD was successfully performed in all 22 patients – no open conversions were required. There was no mortality and there were no perioperative complications. Mean duration of surgery was 101.9 min (59–117 min) and operative blood loss was <150 ml in all cases (10–150 ml). Mean length of hospital stay was 3.2 (2–6) days and return to normal activities was achieved after a mean of 15 (10–30) days. At a mean follow-up of 60 (22–93) months, 17 patients (77%) were completely relieved of symptoms, while 5 (23%) patients complained of some pain not requiring any analgesia. Renal ultrasonography showed an absence of radiological recurrence of the symptomatic renal cyst in all cases. Conclusion: RLD is a safe and effective method to treat symptomatic renal cysts, with an immediate postoperative symptomatic relief, a short convalescence period and effective 5-year clinical and radiological outcome.

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