Giant cysts, no incisions: Ultrasound-guided sclerotherapy in the elderly

Ultrasound (US)-guided sclerotherapy is effective for hepatic and renal cysts, but data on giant cysts are limited, especially in elderly patients prone to recurrence. This study assessed the efficacy of US-guided tube drainage with medical anhydrous ethanol in treating giant hepatic and renal cysts. In this dual-center retrospective study, 55 patients with giant hepatic or renal cysts underwent US-guided percutaneous tube drainage and ethanol sclerotherapy in Zhejiang Hospital and Lijiang People's Hospital from February 2023 to February 2024. Clinical outcomes and adverse events were analyzed. Potential confounders were addressed through strict inclusion/exclusion criteria, standardized procedures, and multivariate adjustment. One year after surgery, efficacy was comparable between the ethanol flushing and flushing-retention methods. For the cyst volume reduction rate (VRR) at 3 months post-surgery, cyst type (β = 0.113, P < .001), treatment method (β = -0.060, P = .018), and maximum diameter (β = -0.009, P = .019) were independent influencing factors. Furthermore, age (β = 0.004, P = .023) and treatment method (β = -0.095, P = .014) were independent predictors of VRR at 1 year postoperatively. Maximum cyst diameter was the only independent factor influencing recurrence (OR = 1.35, P = .009). US-guided tube drainage and sclerotherapy with medical anhydrous ethanol is an effective, minimally invasive option for giant hepatic and renal cysts, offering a valuable strategy for elderly patients.