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The current strategy for urachal remnants.

Hideaki Sato1, Shigeyuki Furuta, Shiho Tsuji

  • 1Department of Pediatric Surgery, St. Marianna University Yokohama City Seibu Hospital, 1197-1, Yasashi-cho, Asahi-ku, Yokohama, Kanagawa, 241-0811, Japan, s-hideaki@marianna-u.ac.jp.

Pediatric Surgery International
|April 22, 2015
PubMed
Summary

Conservative management is recommended for young children with urachal remnants (UR), except for recurrent infections. Older children benefit from laparoscopic surgery for urachal remnant treatment, showing reduced hospital stays and fewer complications.

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Area of Science:

  • Pediatric Surgery
  • Urology

Background:

  • Optimal management for pediatric urachal remnants (UR) remains debated.
  • Nonoperative management is a viable alternative for symptomatic UR.
  • Laparoscopic approaches are increasingly used, but indications require clarification.

Purpose of the Study:

  • To review institutional experience with urachal remnant management.
  • To determine the optimal treatment strategy based on patient age and UR type.
  • To compare outcomes of different surgical approaches.

Main Methods:

  • Retrospective chart review of 27 pediatric patients with UR (1990-2013).
  • Analysis of patient demographics, symptoms, UR type, treatment, and outcomes.
  • Comparison of outcomes between umbilical approach (UA) and laparoscopic approach (LA).

Main Results:

  • Urachal sinus was the most common type (59%).
  • Infants (<1 year) often presented with umbilical granulation, while older children (>1 year) had abdominal pain.
  • Laparoscopic surgery in older children showed a trend towards shorter hospital stays and no operative complications, unlike the umbilical approach.

Conclusions:

  • Conservative follow-up is advised for UR in children under one year, unless recurrent infections necessitate intervention.
  • The umbilical approach is sufficient for infants.
  • Laparoscopic surgery is recommended for older children with urachal remnants.