Research Article
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Laparoscopy Assisted Management of Urachal Anomalies In Children; A Relief for The Surgeon and the Patient?

Year 2022, Volume: 13 Issue: 1, 107 - 111, 01.01.2022
https://doi.org/10.31067/acusaglik.986857

Abstract

Anomalies of the urachus constitute a challenge for the physcian and a source of anxiety for the parents. As the significance of the condition and borders between normal and abnormal are not clear, management is controversial. Although not universal, common indications for surgery are presence of symptoms (infection, pain etc) and fear of malignant transformation.
Materials And Methods
The children who underwent a laparoscopic surgery for a condition related to urachal remnants between 2007 and 2019 are enrolled in the study. Demographics of the patients, intraoperative complications and histological results were retrospectively evaluated and surgical procedure is described.
Results
A total 13 patients were included in the study. Seven patients had urachal cyst (53%),3 had urachal sinus (23%), 1 patent urachus (8%), 1 omphalomesenteric band remnant (8%) and could not be classified in 1 (8%). Three ports were employed in 6 patients, 4 ports in 4 and 1 port in 2 and 2 ports in 1.Peritoneal contamination could not be avoided in 1 patient with infected urachal cyst during the operation, but postoperative course was uneventful in this patient.
Conclusion
Although surgical excision is the most commonly recommended management modality for urachal remnants, both parents and physicians hesitate due to the mysterious nature and insufficient data about the long term consequences of the condition. Choosing the best incision is also an issue and physicians may regret for any of the incisions as they may be ‘too extensive’ or ‘insufficient’. Laparoscopic approach provides satisfactory identification of the condition, superior exposure and cosmesis, and at the worst scenario, a chance to select the most appropriate incision.

Project Number

yok

References

  • Referans1 Stopak JK, Azarow KS, Abdessalam SF, Raynor SC, Perry DA, Cusick RA. Trends in surgical management of urachal anomalies. Journal of pediatric surgery 2015;50:1334-7.
  • Referans2 Upadhyay V, Kukkady A. Urachal remnants: an enigma. European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery [et al] = Zeitschrift fur Kinderchirurgie 2003;13:372-6.
  • Referans3 Ozbek SS, Pourbagher MA, Pourbagher A. Urachal remnants in asymptomatic children: gray-scale and color Doppler sonographic findings. Journal of clinical ultrasound : JCU 2001;29:218-22.
  • Referans4 Nogueras-Ocaña M, Rodríguez-Belmonte R, Uberos-Fernández J, Jiménez-Pacheco A, Merino-Salas S, Zuluaga-Gómez A. Urachal anomalies in children: surgical or conservative treatment? Journal of pediatric urology 2014;10:522-6.
  • Referans5 Hinman's Atlas of Pediatric Urologic Surgery, 2nd edition In: Hinman F BL, editor.: by Saunders, an imprint of Elsevier Inc.; 2019.
  • Referans6 Chiarenza SF, Scarpa MG, D'Agostino S, Fabbro MA, Novek SJ, Musi L. Laparoscopic excision of urachal cyst in pediatric age: report of three cases and review of the literature. Journal of laparoendoscopic & advanced surgical techniques Part A 2009;19 Suppl 1:S183-6.
  • Referans7 Ahmed H, Howe AS, Dyer LL, Fine RG, Gitlin JS, Schlussel RN, et al. Robot-assisted Laparoscopic Urachal Excision in Children. Urology 2017;106:103-6.
  • Referans8 Luo CC, Huang CS, Wu WC, Chu SM, Chao HC. An unusual presentation of an infected urachal cyst: case report and review of the literature. European journal of pediatrics 2004;163:268-9. Referans9 Iuchtman M, Rahav S, Zer M, Mogilner J, Siplovich L. Management of urachal anomalies in children and adults. Urology 1993;42:426-30.
  • Referans10 Ashley RA, Inman BA, Routh JC, Rohlinger AL, Husmann DA, Kramer SA. Urachal anomalies: a longitudinal study of urachal remnants in children and adults. The Journal of urology 2007;178:1615-8.
  • Referans11 Okegawa T, Odagane A, Nutahara K, Higashihara E. Laparoscopic management of urachal remnants in adulthood. International journal of urology : official journal of the Japanese Urological Association 2006;13:1466-9.
  • Referans12 Rich RH, Hardy BE, Filler RM. Surgery for anomalies of the urachus. Journal of pediatric surgery 1983;18:370-2.
  • Referans13 Moore TC. Omphalomesenteric duct malformations. Seminars in pediatric surgery 1996;5:116-23.
  • Referans14 Gleason JM, Bowlin PR, Bagli DJ, Lorenzo AJ, Hassouna T, Koyle MA, et al. A comprehensive review of pediatric urachal anomalies and predictive analysis for adult urachal adenocarcinoma. The Journal of urology 2015;193:632-6.
  • Referans15 Bruins HM, Visser O, Ploeg M, Hulsbergen-van de Kaa CA, Kiemeney LA, Witjes JA. The clinical epidemiology of urachal carcinoma: results of a large, population based study. The Journal of urology 2012;188:1102-7.
  • Referans16 Osumah TS, Granberg CF, Butaney M, Gearman DJ, Ahmed M, Gargollo PC. Robot-Assisted Laparoscopic Urachal Excision Using Hidden Incision Endoscopic Surgery Technique in Pediatric Patients. Journal of endourology 2021;35:937-43.
Year 2022, Volume: 13 Issue: 1, 107 - 111, 01.01.2022
https://doi.org/10.31067/acusaglik.986857

Abstract

Supporting Institution

yok

Project Number

yok

References

  • Referans1 Stopak JK, Azarow KS, Abdessalam SF, Raynor SC, Perry DA, Cusick RA. Trends in surgical management of urachal anomalies. Journal of pediatric surgery 2015;50:1334-7.
  • Referans2 Upadhyay V, Kukkady A. Urachal remnants: an enigma. European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery [et al] = Zeitschrift fur Kinderchirurgie 2003;13:372-6.
  • Referans3 Ozbek SS, Pourbagher MA, Pourbagher A. Urachal remnants in asymptomatic children: gray-scale and color Doppler sonographic findings. Journal of clinical ultrasound : JCU 2001;29:218-22.
  • Referans4 Nogueras-Ocaña M, Rodríguez-Belmonte R, Uberos-Fernández J, Jiménez-Pacheco A, Merino-Salas S, Zuluaga-Gómez A. Urachal anomalies in children: surgical or conservative treatment? Journal of pediatric urology 2014;10:522-6.
  • Referans5 Hinman's Atlas of Pediatric Urologic Surgery, 2nd edition In: Hinman F BL, editor.: by Saunders, an imprint of Elsevier Inc.; 2019.
  • Referans6 Chiarenza SF, Scarpa MG, D'Agostino S, Fabbro MA, Novek SJ, Musi L. Laparoscopic excision of urachal cyst in pediatric age: report of three cases and review of the literature. Journal of laparoendoscopic & advanced surgical techniques Part A 2009;19 Suppl 1:S183-6.
  • Referans7 Ahmed H, Howe AS, Dyer LL, Fine RG, Gitlin JS, Schlussel RN, et al. Robot-assisted Laparoscopic Urachal Excision in Children. Urology 2017;106:103-6.
  • Referans8 Luo CC, Huang CS, Wu WC, Chu SM, Chao HC. An unusual presentation of an infected urachal cyst: case report and review of the literature. European journal of pediatrics 2004;163:268-9. Referans9 Iuchtman M, Rahav S, Zer M, Mogilner J, Siplovich L. Management of urachal anomalies in children and adults. Urology 1993;42:426-30.
  • Referans10 Ashley RA, Inman BA, Routh JC, Rohlinger AL, Husmann DA, Kramer SA. Urachal anomalies: a longitudinal study of urachal remnants in children and adults. The Journal of urology 2007;178:1615-8.
  • Referans11 Okegawa T, Odagane A, Nutahara K, Higashihara E. Laparoscopic management of urachal remnants in adulthood. International journal of urology : official journal of the Japanese Urological Association 2006;13:1466-9.
  • Referans12 Rich RH, Hardy BE, Filler RM. Surgery for anomalies of the urachus. Journal of pediatric surgery 1983;18:370-2.
  • Referans13 Moore TC. Omphalomesenteric duct malformations. Seminars in pediatric surgery 1996;5:116-23.
  • Referans14 Gleason JM, Bowlin PR, Bagli DJ, Lorenzo AJ, Hassouna T, Koyle MA, et al. A comprehensive review of pediatric urachal anomalies and predictive analysis for adult urachal adenocarcinoma. The Journal of urology 2015;193:632-6.
  • Referans15 Bruins HM, Visser O, Ploeg M, Hulsbergen-van de Kaa CA, Kiemeney LA, Witjes JA. The clinical epidemiology of urachal carcinoma: results of a large, population based study. The Journal of urology 2012;188:1102-7.
  • Referans16 Osumah TS, Granberg CF, Butaney M, Gearman DJ, Ahmed M, Gargollo PC. Robot-Assisted Laparoscopic Urachal Excision Using Hidden Incision Endoscopic Surgery Technique in Pediatric Patients. Journal of endourology 2021;35:937-43.
There are 15 citations in total.

Details

Primary Language English
Subjects Surgery, Paediatrics, Urology
Journal Section Research Article
Authors

Beytullah Yağız 0000-0003-0882-1789

Project Number yok
Early Pub Date October 14, 2021
Publication Date January 1, 2022
Submission Date August 25, 2021
Published in Issue Year 2022Volume: 13 Issue: 1

Cite

EndNote Yağız B (January 1, 2022) Laparoscopy Assisted Management of Urachal Anomalies In Children; A Relief for The Surgeon and the Patient?. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 13 1 107–111.