Renal cyst puncture and aspiration: a survey of complications

Complications of cyst puncture and aspiration were analyzed in a survey of 5,674 cases reported by 84 institutions. The mean incidence of major complications was 1.4%. For institutions with extensive experience, the incidence of major complications was 0.75%. Minor complications occurred in probably 10% of all patients but were only detectable at institutions undertaking routine followup. Flexible and malleable equipment for puncture lessened the risk of major complications. Approach to lesions in the upper poles of the kidneys via an oblique pathway using fluoroscopic or ultrasound guidance decreased the risk of pneumothorax compared to direct introduction of the needle through the ultrasound transducer. The incidence of complications did not correlate with number of puncture attempts, gauge of puncture equipment utilized, or completeness of cyst evacuation.