Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
World J Urol. 2012 Oct;30(5):647-50. doi: 10.1007/s00345-012-0829-x.
The traditional surgical approach for removing a urachal remnant is via a large transverse or midline infraumbilical incision. We review our experience with laparoscopic urachal cyst excision and report the efficacy and outcomes of this approach as a less morbid, minimally invasive alternative.
Between August 2005 and March 2009, eight patients with a mean age of 26 years who had symptomatic urachal cysts underwent laparoscopic radical excision of the urachal remnant. Using three ports, the urachal remnant was dissected from the umbilicus to the bladder dome and then removed intact via the umbilicus. Umbilicoplasty was performed by a plastic surgeon. We retrospectively reviewed the perioperative records to assess morbidity and outcomes.
All eight operations were completed successfully. No intraoperative or postoperative complications were reported at a mean follow-up of 3.2 years. Mean operative time was 147.5 min including umbilicoplasty. Pathological evaluation confirmed a benign urachal remnant in each case. There have been no recurrences of symptoms nor postoperative complications during follow-up. Mean time to full recovery, defined as return to normal life without pain, was 16 days. The patients with bladder cuff resection had a delayed full convalescence (25 vs. 13 days) due to a minimum degree of dysuria.
A laparoscopic approach with the removal of urachal remnants via the umbilicus appears to be a safe and effective alternative with better cosmesis when compared to an open approach.
传统的脐尿管残余切除术式为大的横切口或中线下腹正中切口。我们回顾了腹腔镜脐尿管囊肿切除术的经验，并报告了这种术式的疗效和结果，认为其是一种创伤更小、更微创的替代方法。
2005 年 8 月至 2009 年 3 月，8 例有症状的脐尿管残余患者接受了腹腔镜根治性脐尿管残余切除术，平均年龄 26 岁。使用 3 个套管针，从脐部向膀胱顶部分离脐尿管残余，然后经脐部完整切除。脐成形术由整形外科医生完成。我们回顾性地分析了围手术期记录，以评估发病率和结果。
8 例手术均顺利完成。在平均 3.2 年的随访中，无术中或术后并发症。平均手术时间为 147.5 分钟，包括脐成形术。病理评估证实所有病例均为良性脐尿管残余。随访中无症状复发或术后并发症。定义为无疼痛、恢复正常生活的完全康复时间为 16 天。膀胱袖状切除术患者的完全康复时间延迟（25 天比 13 天），因为存在轻度排尿困难。
与开放式手术相比，经脐腹腔镜切除脐尿管残余术式安全有效，美容效果更好。
