The study of 1,342 renal cysts gathered from various centres emphasized the great diversity of the therapeutical approach. In this series, 1 patient out of 2 was operated on and 1 out of 6 operations was a nephrectomy. The mortality was 1.2 % and complications occurred in 10 % of the cases. Arguments in favour of systematic surgery are severely criticized and the risk of failure to recognize a cancer associated with a cyst is very small: when this association was encountered, there were warning signs or symptoms. Percutaneous puncture of the cyst may suffice for diagnosis and treatment of most cases. When surgery is indicated for a cyst as in doubtful diagnosis, symptoms from the swelling or in association with lithiasis, resection of the dome of the cyst is the operation of choice. Considering the extraordinary recovery of the renal parenchyma, the necessity for nephrectomy must be quite exceptional.

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