Bawahab Mohammed A
Department of Surgery, Faculty of Medicine, King Khalid University, Abha, Saudi Arabia.
J Minim Access Surg. 2023 Apr-Jun;19(2):217-222. doi: 10.4103/jmas.jmas_72_22.
To report our experience in the laparoscopic management of symptomatic urachal remnants (URs) in adults.
A retrospective study included all patients who underwent laparoscopic excision of URs during the period January 2015-January 2020. The following data were retrieved from the files of the patients: demographic data, clinical presentations, intra-operative findings, the procedure performed, operative details, intraoperative or post-operative complications and follow-up period mentioned in the files for those patients.
The study included 10 patients (four males and six females) with a mean age of 27.8 ± 11.0 years. URs were discovered preoperatively in all patients except one patient who was diagnosed intraoperatively. URs were associated with other pathologies in four patients (40%) that required two simultaneous surgical procedures. Eight patients (80%) presented with simple umbilical discharge and were diagnosed easily by ultrasonography. All patients were managed successfully with laparoscopic excision and umbilical sparing technique. Excision of the dome of the bladder was done on the selective approach to one patient. No patients showed early post-operative complications. Only one patient had stitch sinus 6 months postoperatively due to a concomitant hernia repair rather than due to the excision of the URs.
Laparoscopic excision of symptomatic urachus is a feasible procedure even when the excision of the bladder is required. It could be performed successfully with other pathologies. It is associated with a low incidence of complications. Laparoscopy allows good visualisation and complete excision that leads to almost no recurrence rate.
报告我们在成人有症状脐尿管残余物（URs）的腹腔镜治疗方面的经验。
一项回顾性研究纳入了2015年1月至2020年1月期间接受腹腔镜下脐尿管残余物切除术的所有患者。从患者病历中获取以下数据：人口统计学数据、临床表现、术中发现、所实施的手术、手术细节、术中或术后并发症以及病历中提及的这些患者的随访期。
该研究包括10例患者（4例男性和6例女性），平均年龄为27.8±11.0岁。除1例术中诊断的患者外，所有患者术前均发现有脐尿管残余物。4例患者（40%）的脐尿管残余物与其他病理情况相关，需要同时进行两项手术。8例患者（80%）表现为单纯脐部渗液，通过超声检查容易诊断。所有患者均通过腹腔镜切除和保留脐部技术成功治疗。对1例患者采用选择性方法切除了膀胱顶部。没有患者出现早期术后并发症。只有1例患者术后6个月因同时进行疝修补而非脐尿管残余物切除出现缝线窦。
即使需要切除膀胱，腹腔镜下切除有症状的脐尿管也是一种可行的手术。它可以与其他病理情况同时成功进行。其并发症发生率较低。腹腔镜检查可实现良好的可视化和完整切除，几乎不会导致复发率。
