Dissection of large kidney cysts

Patient Vo Van Suong (56 years old, District 12, Ho Chi Minh City) was diagnosed with a right kidney having a cyst, the size of a thumb, since 2000. At that time, the doctor recommended surgery to treat kidney cysts but he hesitated, self-monitoring at home. His kidney pain recurred right in the days when Ho Chi Minh City entered the 4th wave of the epidemic, but he was not hospitalized for fear of contracting Covid-19.

Recently, Mr. Suong was hospitalized at Tam Anh General Hospital in Ho Chi Minh City with a high fever, chills, severe hip pain… In particular, the patient’s right hip and back area was very swollen. Mr. Suong said that the day before being admitted to the hospital, he still had normal activities, only felt a few dull pain. However, at night, the pain increased gradually.

Through the test results and imaging, the doctor determined that the patient had a renal cyst occupying the retroperitoneal space, the position of the right adrenal fossa, the size of 10×15.6×16.5 cm. The kidney cyst was infected.

Assoc. Prof. TS.BS Vu Le Chuyen, Director of the Center for Urology and Nephrology, assessed that this complex injury causes compression and pushes the patient’s right kidney forward and downward. The solution is to drain fluid from the kidney cyst to relieve pressure and reduce infection, use antibiotics, relieve pain, and reduce fever. When the infection is temporarily under control, the doctor will perform cystectomy to thoroughly treat the kidney cyst for the patient.

Initially, the patient exploratory surgery by endoscopic method. However, through investigation, the doctors found that the retroperitoneal cyst was firmly attached to a mass, about 15 cm in size, with thick wall, suspected of being a tumor, so open surgery was required.

When approaching this large cystic tumor, the doctor found a lot of necrotic tissue, cloudy brown fluid. The tumor developed over many years, so it adhered to the abdominal wall, the capsule shell was located deep in the right liver, leading to very difficult dissection, causing a lot of bleeding. After 5 hours of surgery, with 5 units of blood (about 1 liter of blood), the tumor was completely dissected and transferred to the laboratory for assessment on pathology.

“I found myself recovering about 70%, my blood pressure was stable, the person was awake, started walking again so that my body could recover quickly,” Mr. Suong shared a few days after the operation.

According to Associate Professor Chuyen, kidney tumor (tumor) is one of the complicated and dangerous diseases. Tumors are usually more than 3 cm in size, located at the poles of the kidney. The three typical symptoms of a kidney tumor include: hematuria, pain in the hips and back, and a tumor at a late stage. However, the disease has very vague manifestations such as low-grade fever, weight loss, anemia, easy fatigue… so patients are often overlooked or misdiagnosed. By the time there are signs of metastasis such as supraclavicular lymph nodes, large liver, edema of both legs, etc., the disease is already at a late stage, treatment is complicated, takes a long time and is not effective.

Associate Professor Chuyen advises patients to build a healthy lifestyle, stay away from alcohol, reduce stress, and exercise. Everyone should have a health checkup every 6 months, or according to the doctor’s appointment, especially for people over 40 years old. When there are abnormal signs, they must be examined and consulted by a specialist in a timely manner. To avoid dangerous diseases and complications such as kidney failure, kidney cancer… should regularly screen kidney function to protect the health of this organ.

Mr. Thai