Kim Hakushi, Nakajima Serina, Kawamura Yoshiaki, Shoji Sunao, Hoshi Akio, Uchida Toyoaki, Terachi Toshiro, Miyajima Akira
Department of Urology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
Department of Plastic Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
Int Urol Nephrol. 2017 Nov;49(11):1965-1971. doi: 10.1007/s11255-017-1678-8. Epub 2017 Aug 21.
Symptomatic urachal remnants are rare benign anomalies affecting young adults. For these patients, both curative treatment and acceptable postoperative aesthetic outcomes are important. Here, we describe a novel transumbilical approach, using Y-shaped incisions and three-flap umbilicoplasty techniques, to improve repair and aesthetic outcomes.
The clinical and perioperative data of 16 patients (11 men; median age, 25 years; range 16-46 years) who underwent LESS surgery and three-flap umbilicoplasty (LESS group) between December 2013 and March 2017 were analyzed. For comparison, the perioperative data of those who underwent conventional laparoscopic surgery (CL group) between May 2010 and November 2013 at the same institutions were investigated.
The median operative time of the LESS group was longer than that of the CL group (146.5 vs 107 min; p = 0.009). The estimated blood loss and postoperative hospital stay were not significantly different between the two groups. The two perioperative complications were injury to the transverse colon serosa and minor surgical site infection. Both complications were resolved with appropriate management.
This novel umbilical approach is useful for patients with symptomatic urachal remnants, with the reduction in port-site scarring resulting in good postoperative cosmesis.
有症状的脐尿管残余是影响年轻人的罕见良性异常。对于这些患者，根治性治疗和可接受的术后美学效果都很重要。在此，我们描述一种新颖的经脐入路，采用Y形切口和三瓣脐成形术技术，以改善修复效果和美学结果。
分析了2013年12月至2017年3月期间接受LESS手术和三瓣脐成形术的16例患者（11例男性；中位年龄25岁；范围16 - 46岁）的临床和围手术期数据（LESS组）。为作比较，调查了2010年5月至2013年11月在同一机构接受传统腹腔镜手术的患者（CL组）的围手术期数据。
LESS组的中位手术时间比CL组长（146.5对107分钟；p = 0.009）。两组之间的估计失血量和术后住院时间无显著差异。围手术期有2例并发症，分别为横结肠浆膜损伤和轻微手术部位感染。经适当处理后，两种并发症均得到解决。
这种新颖的脐入路对有症状的脐尿管残余患者有用，减少了穿刺孔瘢痕形成，术后美容效果良好。
