Clinical Study

Symptomatic Abdominal Simple Cysts: Is Percutaneous Sclerotherapy with Hypertonic Saline and Bleomycin a Treatment Option?

Table 5

Reported percutaneous treatment of simple cystic lesions.

AuthorsDrainage catheter/
sclerosant used
Organ of cysts’ locationNumber of sessions/duration of follow-upComplications/
percentage
Complete regression (CR) at one year (disappearance of the cyst, after the first session)Near-CR at one year (volume reduction rate, after the first session >85%)Partial regression at one year (volume reduction rate, after the first session 50–85%)No response at one year (volume reduction rate <50%)

Saini et al. [9]No (aspiration, only)/noneLiverOne or two/up to 24 mos.0%0%0%100%

*Zerem et al. [1]Yes/group I: prolonged catheter drainage for 24 hours
Group II: ethanol, retention for two hours
Liver One (or two in 12.5% of group I & 26.01 of group II)/24 mos.Group I: pain/16.6%
Group II: pain/30.4%, fever/13%, drunkenness/30.4%, headache/26.01%, and deep sleep/8.7%
Group I: 66.7%
Group II: 47.8%
ObscureObscureObscure

Kairaluoma et al. [58]Yes/ethanolLiverOne or two/12 to 32 mos.Pain, fever, and nausea-vomiting/72.7%37.5%62.5%

Montorsi et al. [59]Yes/ethanolLiverOne/6 to 60 mos.Pain, fever/9.5%71.4% (follow-up period 12–24 mos.)ObscureObscure28.5%

Larssen et al. [60]Yes/ethanolLiverOne/12 to 47 mos.Pain/80%30%40%20%10%

*Yang et al. [61]Yes*/ethanol group I: 4-hour retention, group II: 2-hour retentionLiverOne/9 to 59 mos.Intractable pain (32.26%), symptoms and signs of drunkenness (80.6%), flushing and headache (54%), skin rash (9.6%), deep sleep (6.4%), and blood pressure of 30–50 mm Hg (22.56%).16.12%ObscureObscureObscure

Zerem et al. [62]Yes. Two groups: continuous 24-hour catheter evacuation (I) and drainage for two hours (II)/ethanolKidneyOne/24 mos.Pain/44.3% [moderate in 26.09% of cases, severe in 17.4%] 40% (at 24-month follow-up, 52% of continuous group I and 28% of group II) ObscureObscure7.06%

Touloupidis et al. [30]Yes, continuous drainage of the cyst for 24 h/ethanol, retention for 20 minKidneyOne or multiple (in most of cases)/5 yearsPain/obscure, purulence of the cyst that required open surgery/0.4%07.0%22.0%Obscure

Lin et al. [63]Yes/ethanol group I: 4-hour retention, group II: 2-hour retentionKidneyOne/12 mos. (at least)Pain (most mild to moderate, severe 13.9%), nausea, causalgia, drunkenness, perforation to the collecting system (2.7%)Group I: 21.4%, group II: 52.4%65.7%2.8%0

Akinci et al. [47]Yes/ethanolKidneyOne/12 to 85 mos.Retroperitoneal hematoma, spontaneous hemorrhage into the cyst cavity/2%11.2% (17.5%, during the total follow-up period)ObscureObscureObscure

Cho et al. [64]Yes/acetic acid (group I) and ethanol (group II)KidneyOne/group I: 18 mos., group II: 13 mos.Pain/group I: 48.3%, group II: 12.5 Group I: 90.6%
Group II: 60%
Group I: 9.4% 0%
Group II: 30%

Kwon et al. [31]Yes/50% acetic acid (group I: sclerosant retention into cyst for 20 min, group II: retention for 5 min)KidneyOne/group I: 12 to 52 mos., group II: 7 to 48-mos.Pain/7.7% Group I: 53.1%
Group II: 48.57%
CR, during the total follow-up period:
group I: 66%
group II: 63%
All the rest, during the total follow-up period Percentage of the reduction rate of the cyst’s volume:
group I: 97.4%% 
group II: 96.9%
00

Nakaoka et al. [49]Yes/ethanolamine oleateLiver ( PLD and simple cysts)One or two (one patient)/<1 (two patients) up to 95 mos. (median 44.4 mos.) Pain (mild to severe), vasovagal reflex, and mild fever/64.7%88.4% (total)

Yamamoto et al. [32]Yes/ethanolamine oleateLiver, kidneyOne/4 to 10 mos.Fever/28.5%0100%00

Yoshida et al. [65] Yes/minocycline hydrochlorideLiverSession repeated daily for 7-8 days/42 to 153 mos.Pain/22.2%100%0%0%0%

Jusufovic and Zerem [50]Yes/20% NaCl solutionLiverOne/24 mos.40.0%55%5%0

Li et al. [51]No (aspiration, only)/bleomycinKidney One/12 mos.No major47.0%36.4%15.1%1.5%

2% lidocaine was injected into the cyst after evacuation and before treatment for pain relief.