Aspiration-Sclerotherapy Versus Laparoscopic De-roofing in the Treatment of Symptomatic Renal Cysts: A Systematic review and meta-analysis

Background: Renal cyst is prevailing around the world and symptomatic renal cysts are recommended to be treated in the EUA guidelines. Currently, aspiration-sclerotherapy (AS) and laparoscopic de-roofing (LD) are the main therapies of symptomatic renal cysts. This article aims to compare the clinical efficiency between them in the management of renal cysts through meta-analysis of comparative studies. Method: A comprehensive literature search was performed by PubMed, MEDLINE, EMBASE and the Cochrane Library to ascertain the relevant studies published up to March 2019. Articles with English full-text comparing aspiration-sclerotherapy and laparoscopic de-roofing in renal cyst treatment were included. Results: Our searches of literature generated 6 studies (1547 patients incorporated) comparing AS with LD in the impacts of renal cyst therapy. Of these, 6 studies contained 1106 and 441 patients who were treated with AS and LD, respectively. The outcome of this meta-analysis indicated that although AS group had shorter treatment time (MD：-51.10; 95% CI：-73.01 to -29.20; p<0.01), radiological successful rate (RR: 0.64; 95%CI: 0.53 to 0.77) are higher in LD group, which also had less recurrence rate (RR: 4.96; 95%CI: 2.28 to 10.81; p<0.01). No statistically significant difference was showed in symptomatic successful rate (RR: 0.90; 95%CI: 0.79 to 1.03；P=0.13) and complications (RR: 2.11; 95% CI: 0.47 to 9.52; P=0.33). Conclusion: In our meta-analysis, laparoscopic de-roofing is superior to aspiration-sclerotherapy in radiological successful rate and recurrence, but the treatment time is longer.