Varvashenya M. Chase of the tactic of mini invasive endourological manipulations in patients with simple renal cysts.

The thesis is devoted to the decision of urology specific problem concerning diagnostic methods and peculiarities of surgical treatment of patients with simple renal cysts depending on their localization and protein level in the contents of the cyst. On the base of the conducted complex of research methods it was settled that conducting of percutaneous igniopuncture of simple renal cyst with aspiration of its contents, temporal drainage and followed sclerotherapy decreases the level of cyst's recurrence in comparison with percutaneous igniopuncture with aspiration, and followed sclerotherapy without temporal drainage. It is revealed that analysis of protein contents in cystic fluid is a preferable analysis for prognosis of cyst's recurrence. A high protein level (5 g/l and more) is connected with a high risk of cyst's recurrence during the first year after operation. In the histological samples of the recurrent renal cyst it is noted the thickness decreasing of the outer and inner cystic walls because of tissue fibrosis. The structure of the cystic wall is characterized by inequality of cystic wall thickness, thickening of vascular walls, obliteration of lymphatic vessels, nephrogenic tissue sclerosis, glomerular deformation and thickening of its walls, large lymphocytic and hemorrage infiltrations, etc. Retroperitoneal endourologic way of surgical approach is approved for the radical surgical treatment of renal cysts. The algorithm of diagnosis and treatment of patients with simple renal cysts is proposed in the work. It is settled that in patients with simple renal cysts and protein level less than 5 g/l the preferred method is a method of percutaneous igniopuncture of simple renal cyst with aspiration of its contents, temporal drainage and followed sclerotherapy. In the case of a high protein level in the cystic contents (5 g/l and more) notwithstanding the size of the cyst, the preferred method is a radical endovideourologic resection of simple renal cyst using retroperitoneal approach.