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Laparoscopic management of urachal remnants in children

Year 2017, Volume: 34 Issue: 2, 89 - 92, 08.09.2017

Abstract


Urachal remnant is an uncommon congenital anomaly which is caused by the

persistence of embryologic communication between the bladder and the umbilicus.

The surgical approach to these remnants has been open for years but

endoscopic surgery has become more popular because of its better cosmetic

results, less postoperative pain and faster returns to daily activities. The aim of

this study is to present 17 cases of urachal remnants that were treated by laparoscopic

excision. Retrospective review was performed included all patients

diagnosed with an urachal remnant (UR) and underwent laparoscopic excision

between January 2009 and January 2015. Patient variables included age, gender,

presenting symptoms, diagnostic modality, type of urachal remnant, operative

time, post-operative complications and follow-up were recorded. Laparoscopic

surgery was performed using three ports. The urachal remnant was excised

starting from the umbilicus to the bladder dome by cauterization. Stump on the

bladder was ligated with endoloop sutures. We identified 17 pediatric patients

with an urachal cyst (n=8), urachal diverticulum (n=4), urachal sinus (n=4) and

patent urachus (n=1). Median age of the patients was 7 years (5 months-17

years). All patients had symptomatic URs. Abdominal pain (n=8), umbilical

discharge (n=6), and umbilical mass (n=3) were presenting symptoms. Ultrasonography

confirmed the diagnosis of urachal remnant in all children. Mean

operating time was 30 minutes (12-60 minutes). No intraoperative or postoperative

complications were reported at a mean follow-up of 28 months. Histopatological

examination revealed benign urachal remnant. Laparoscopic excision

of urachal remnants is a preferable alternative to traditional open surgery with

better postoperative analgesia, cosmetic results and rapid healing. Laparoscopic

approach is an effective and minimal invasive technique to treat of urachal

remnants in children.


References

  • Bertozzi, M., Riccioni, S., Appignani, A., 2014. Laparoscopic treatment of symptomatic urachal remnants in children. J. Endourol. 28, 1091-1096. doi: 10.1089/end.2014.0203. Chiarenza, S.F., Scarpa, M.G., D’Agostino, S., Fabbro, M.A., Novek, S.J., Musi, L., 2009. Laparoscopic excision of urachal cyst in pediatric age: Report of three cases and review of the literature. J. Laparoendosc. Adv. Surg. Tech. A. 19, 183-186. doi: 10.1089/lap.2008.0184. Cutting, C.W., Hindley, R.G., Poulsen, J., 2005. Laparoscopic management of complicated urachal remnants. BJU Int. 96, 1417- 1421. Fahlenkamp, D., Schönberger, B., Lindeke, A., Loening, S.A., 1995. Laparoscopic excision of the sinusoidal remnants of the urachus in a 3-year-old boy. Br. J. Urol. 76, 135-137. Fanning, D.M., Sabah, M., Conlon, P.J., Mellotte, G.J., Donovan, M.G., Little, D.M, 2011. An unusual case of cancer of the urachal remnant following repair of bladder exstrophy. Ir. J. Med. Sci. 180, 913-915. doi: 10.1007/s11845-009-0310-z. Kojima, Y., Hayashi, Y., Yasui, T., Itoh, Y., Maruyama, T., Kohri, K., 2007. Laparoscopic management for urachal cyst in a 9-yearold boy. Int. Urol. Nephrol. 39, 771-774. Kurtz, M., Masiakos, P.T., 2008. Laparoscopic resection of a urachal remnant. J. Pediatr. Surg. 43, 1753-1754. doi:10.1016/j. jpedsurg.2008.04.021. Masuko, T., Uchida, H., Kawashima, H., Tanaka, Y., Deie, K., Iwanaka, T., 2013. Laparoscopic excision of urachal remnants is a safe and effective alternative to open surgery in children. J. Laparoendosc. Adv. Surg. Tech. A. 23, 1016-1019. doi: 10.1089/ lap.2013.0127. Sato, H., Furuta, S., Tsuji, S., Kawase, H., Kitagawa, H., 2015. The current strategy for urachal remnants. Pediatr. Surg. Int. 31, 581-587. doi: 10.1007/s00383-015-3712-1. Siow, S.L., Mahendran, H.A., Hardin, M., 2015. Laparoscopic management of symptomatic urachal remnants in adulthood. Asian J. Surg. 38, 85-90. doi: 10.1016/j.asjsur.2014.04.009. Trondsen, E., Reiertsen, O., Rosseland, A.R,1993. Laparoscopic excision of urachal sinus. Eur. J. Surg. 159, 127-128. Yohannes, P., Bruno, T., Pathan, M., Baltaro, R., 2003. Laparoscopic radical excision of urachal sinus. J. Endourol. 17, 475-479.
Year 2017, Volume: 34 Issue: 2, 89 - 92, 08.09.2017

Abstract

References

  • Bertozzi, M., Riccioni, S., Appignani, A., 2014. Laparoscopic treatment of symptomatic urachal remnants in children. J. Endourol. 28, 1091-1096. doi: 10.1089/end.2014.0203. Chiarenza, S.F., Scarpa, M.G., D’Agostino, S., Fabbro, M.A., Novek, S.J., Musi, L., 2009. Laparoscopic excision of urachal cyst in pediatric age: Report of three cases and review of the literature. J. Laparoendosc. Adv. Surg. Tech. A. 19, 183-186. doi: 10.1089/lap.2008.0184. Cutting, C.W., Hindley, R.G., Poulsen, J., 2005. Laparoscopic management of complicated urachal remnants. BJU Int. 96, 1417- 1421. Fahlenkamp, D., Schönberger, B., Lindeke, A., Loening, S.A., 1995. Laparoscopic excision of the sinusoidal remnants of the urachus in a 3-year-old boy. Br. J. Urol. 76, 135-137. Fanning, D.M., Sabah, M., Conlon, P.J., Mellotte, G.J., Donovan, M.G., Little, D.M, 2011. An unusual case of cancer of the urachal remnant following repair of bladder exstrophy. Ir. J. Med. Sci. 180, 913-915. doi: 10.1007/s11845-009-0310-z. Kojima, Y., Hayashi, Y., Yasui, T., Itoh, Y., Maruyama, T., Kohri, K., 2007. Laparoscopic management for urachal cyst in a 9-yearold boy. Int. Urol. Nephrol. 39, 771-774. Kurtz, M., Masiakos, P.T., 2008. Laparoscopic resection of a urachal remnant. J. Pediatr. Surg. 43, 1753-1754. doi:10.1016/j. jpedsurg.2008.04.021. Masuko, T., Uchida, H., Kawashima, H., Tanaka, Y., Deie, K., Iwanaka, T., 2013. Laparoscopic excision of urachal remnants is a safe and effective alternative to open surgery in children. J. Laparoendosc. Adv. Surg. Tech. A. 23, 1016-1019. doi: 10.1089/ lap.2013.0127. Sato, H., Furuta, S., Tsuji, S., Kawase, H., Kitagawa, H., 2015. The current strategy for urachal remnants. Pediatr. Surg. Int. 31, 581-587. doi: 10.1007/s00383-015-3712-1. Siow, S.L., Mahendran, H.A., Hardin, M., 2015. Laparoscopic management of symptomatic urachal remnants in adulthood. Asian J. Surg. 38, 85-90. doi: 10.1016/j.asjsur.2014.04.009. Trondsen, E., Reiertsen, O., Rosseland, A.R,1993. Laparoscopic excision of urachal sinus. Eur. J. Surg. 159, 127-128. Yohannes, P., Bruno, T., Pathan, M., Baltaro, R., 2003. Laparoscopic radical excision of urachal sinus. J. Endourol. 17, 475-479.
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Details

Journal Section Surgery Medical Sciences
Authors

Gulnur Gollu

Gönül Küçük This is me

Ufuk Ates This is me

Bilge Türedi This is me

Farid Khanmammadov This is me

Aydın Yagmurlu This is me

Huseyin Dindar This is me

Meltem Bingol Kologlu This is me

Publication Date September 8, 2017
Submission Date September 7, 2017
Acceptance Date June 23, 2016
Published in Issue Year 2017 Volume: 34 Issue: 2

Cite

APA Gollu, G., Küçük, G., Ates, U., Türedi, B., et al. (2017). Laparoscopic management of urachal remnants in children. Journal of Experimental and Clinical Medicine, 34(2), 89-92.
AMA Gollu G, Küçük G, Ates U, Türedi B, Khanmammadov F, Yagmurlu A, Dindar H, Kologlu MB. Laparoscopic management of urachal remnants in children. J. Exp. Clin. Med. September 2017;34(2):89-92.
Chicago Gollu, Gulnur, Gönül Küçük, Ufuk Ates, Bilge Türedi, Farid Khanmammadov, Aydın Yagmurlu, Huseyin Dindar, and Meltem Bingol Kologlu. “Laparoscopic Management of Urachal Remnants in Children”. Journal of Experimental and Clinical Medicine 34, no. 2 (September 2017): 89-92.
EndNote Gollu G, Küçük G, Ates U, Türedi B, Khanmammadov F, Yagmurlu A, Dindar H, Kologlu MB (September 1, 2017) Laparoscopic management of urachal remnants in children. Journal of Experimental and Clinical Medicine 34 2 89–92.
IEEE G. Gollu, “Laparoscopic management of urachal remnants in children”, J. Exp. Clin. Med., vol. 34, no. 2, pp. 89–92, 2017.
ISNAD Gollu, Gulnur et al. “Laparoscopic Management of Urachal Remnants in Children”. Journal of Experimental and Clinical Medicine 34/2 (September 2017), 89-92.
JAMA Gollu G, Küçük G, Ates U, Türedi B, Khanmammadov F, Yagmurlu A, Dindar H, Kologlu MB. Laparoscopic management of urachal remnants in children. J. Exp. Clin. Med. 2017;34:89–92.
MLA Gollu, Gulnur et al. “Laparoscopic Management of Urachal Remnants in Children”. Journal of Experimental and Clinical Medicine, vol. 34, no. 2, 2017, pp. 89-92.
Vancouver Gollu G, Küçük G, Ates U, Türedi B, Khanmammadov F, Yagmurlu A, Dindar H, Kologlu MB. Laparoscopic management of urachal remnants in children. J. Exp. Clin. Med. 2017;34(2):89-92.