Turial Salmai, Hueckstaedt Thomas, Schier Felix, Fahlenkamp Dirk
Department of Pediatric Surgery, University Medical Center Mainz, Mainz, Germany.
J Urol. 2007 May;177(5):1864-6. doi: 10.1016/j.juro.2007.01.049.
Urachal remnants are generally treated with the open method. We evaluated the role of laparoscopy for this anomaly in a consecutive series of 27 children treated during a 12-year period.
A total of 27 children with a median age of 4.7 years presented with urachal remnants between 1993 and 2006. Two different laparoscopic approaches were used. In the first 9 children a 5 mm laparoscope was inserted at the umbilicus, with working trocars in the left and right upper abdominal wall. In the remaining patients the laparoscope was placed at the left lower abdominal wall, with working ports placed at the left lower and upper abdomen. The working ports were 2 mm trocars. The urachal remnants were ligated and excised by electrocautery, and the bladder-sided stump was ligated with 2 sutures. No drains were used. The specimen were exteriorized via the umbilicus.
Median operative time was 35 minutes. There were no intraoperative or postoperative complications, and no recurrences. Cosmetic results were excellent.
The laparoscopic approach for urachal remnants is safe, allows for better visualization of the anatomy and yields a cosmetic result that is superior to the open approach.
脐尿管残余通常采用开放手术方法治疗。我们对连续12年期间治疗的27例儿童患者进行了腹腔镜手术治疗脐尿管残余异常的研究。
1993年至2006年，共有27例中位年龄为4.7岁的儿童患者出现脐尿管残余。采用了两种不同的腹腔镜手术方法。前9例患儿在脐部插入5mm腹腔镜，操作套管针置于左上腹和右上腹。其余患者将腹腔镜置于左下腹壁，操作孔位于左下腹和上腹部。操作孔为2mm套管针。脐尿管残余用电灼法结扎并切除，膀胱侧残端用2根缝线结扎。未放置引流管。标本经脐部取出。
中位手术时间为35分钟。无术中或术后并发症，无复发。美容效果极佳。
腹腔镜治疗脐尿管残余安全，能更好地观察解剖结构，美容效果优于开放手术。
