Laparoscopic management of urachal remnants in children

Q4 Medicine

中华小儿外科杂志 Pub Date : 2019-12-15 DOI:10.3760/CMA.J.ISSN.0253-3006.2019.12.010

Linfeng Zhu, Yiding Shen, C. Tao, Guangjie Chen, De-hua Wu, Yong Huang, Xiaohao Wang, W. Ru, Rulai Yang, D. Tang

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Abstract

Objective To evaluate the efficacy and approach of laparoscopic excision of urachal remnants in children. Methods From May 2012 to April 2018, retrospective reviews were conducted for medical records of all children undergoing laparoscopic excision of urachal remnants. Results There were 10 boys and 5 girls with a median age of 4.5(0.3-16.8) years. Umbilicus-sparing laparoscopic urachal excision was performed. The causes were urachal cyst (n=11) and patent urachus (n=4). Complete excision (n=11) and conversion into open surgery & partial cystectomy (n=4) were performed. Postoperative antibiotics were offered. All diagnoses were confirmed by pathological examinations. During a follow-up period of 3-60 months, there was no onset of re-infection or cyst recurrence. Conclusions Umbilicus-sparing laparoscopy is both safe and effective for treating persistent or infected urachus. It offers superior cosmetic outcomes. Partial cystectomy depends upon the presence of an adherent communicating urachal cyst attached to bladder dome. For acute infection, antibiotic dosing or initial incision & drainage with delayed cyst excision may be adopted for avoiding unnecessary complications. Key words: Urachus; Therapeutic laparoscopy; Child

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儿童尿管残余的腹腔镜治疗

目的探讨腹腔镜下小儿尿管残余切除术的疗效和方法。方法回顾性分析2012年5月至2018年4月腹腔镜下尿管残余切除术患儿的医疗记录。结果男10例，女5例，中位年龄4.5(0.3 ~ 16.8)岁。行保留脐的腹腔镜尿管切除术。病因为尿管囊肿(11例)和尿管未闭(4例)。全部切除(n=11)，转入开放手术和部分膀胱切除术(n=4)。术后给予抗生素治疗。所有诊断均经病理检查证实。随访3 ~ 60个月，无再感染及囊肿复发。结论保脐腹腔镜手术治疗顽固性或感染性尿路安全有效。它提供了卓越的美容效果。膀胱部分切除术取决于是否存在附着于膀胱穹窿的附连性尿管囊肿。对于急性感染，可采用抗生素给药或先切开引流后延迟囊肿切除，以避免不必要的并发症。关键词:Urachus;腹腔镜治疗;孩子

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来源期刊

中华小儿外科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.40

自引率

0.00%

发文量

8707

期刊介绍： Chinese Journal of Pediatric Surgery is an academic journal sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. The journal was founded in 1980 and is included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences) and CSCD Chinese Science Citation Database Source Journal (including extended version). It is one of the national key academic journals under the supervision of the China Association for Science and Technology. Chinese Journal of Pediatric Surgery enjoys a high reputation and influence in the academic community. The articles published in this journal have a high academic level and practical value, providing readers with a large number of practical cases and industry information, and have received widespread attention and citations from readers.