Management of pediatric patients with urachal remnants


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Background. Management ofthe patients with urachal remnants (URs) has been under discussion for a long time. The traditional approach with surgical removal of all urachal remnants, has been changed to a more conservative, which is preferred by many surgeons, especially in asymptomatic patients. Aim. The purpose of this study was to optimize the treatment of patients with URs, primarily for asymptomatic children. Results. Our previous screening study showed that real incidence of the URs in childhood is significantly higher than it was previously stated. Based on our data and the results of literature review, we propose an algorithm for the workup and treatment of children with URs. Conclusion. We assume that the risk of developing complications (primarily, malignancy) was previously significantly overestimated. In this regard, we recommend conservative tactics in in most asymptomatic cases.

Full Text

Restricted Access

About the authors

I. V Poddubny

A.I. Evdokimov Moscow State University of Medicine and Dentistry

Email: igorpoddoubnyi@yandex.ru
professor, Head of the Department of Paediatric Surgery

Ya. A Isaev

Helios Klinikum Erfurt

Email: doctorisaev@gmail.com
surgeon

References

  1. Enid G.-B., Raj P. Kapur. Potter’s pathology offetus, infant and child. Second edition. Elsevier, 2007. P. 326-328.
  2. Moore K., Persaud T. Before we are born: essentials of embryology and birth defects. Philadelphia, Saunders. 1998. 368 с.
  3. Atala A., Retik A.B. Patent urachus and urachal cysts. In: Burg FD, Ingelfinger J.R,. Wald E.R., editors. Gellis & Kagan’s Current Pediatric Therapy. Philadelphia: WB Saunders; 1993. Р. 386-387.
  4. Gearhart J.P., Jeffs R.D. Urachal abnormalities. In: Walsh PC, Retik AB, Vaughan ED, Wein AJ, Kavoussi LR, Novick AC, et al., editors. Campbell’s Urology. 7th ed. Philadelphia: WB Saunders; 1998. Р. 1984-1987.
  5. Moore K.L. The urogenital system. In: Moore K.L., editor. The developing human. 3rd ed. Philadelphia (Pa): Saunders; 1982. p. 255-297.
  6. Ueno T., Hashimoto H. Urachal anomalies: ultrasonography and management. Journal of pediatric surgery. 2003;38:1203-07.
  7. Nix J.T., Menville M.A. Congenital patent urachus. J Urol.1958;79:264-273.
  8. Bertozzi M., Nardi N. Minimally invasive removal of urachal remnants in childhood. Ped. Med. Chir.2009;31:265-268.
  9. Поддубный И.В., Исаев Я.А., Исаева М.В. Аномалии мочевого протока у детей: скрининговое ультразвуковое исследование. Детская больница. 2015;2(60):16-20.
  10. McCollum M., MacNelly A., Blair G. Surgical implications ofurachal remnants: presentation and management. J Pediatric Surgery 2003;38:798-803.
  11. de La Taille A., Biserte J., Vankemmel O. et al. Urachal remnants: excision or surveillance? Apropos of 3 cases and review of literature. J Urology. 1997;103:56-58.
  12. Colin W.M. Cutting., Richard G. Hindley. Laparoscopic management of complicated urachal remnants. BJU international. 2005;96:1417-1421.
  13. Wright J.L., Porter M.P., Li C.I. Differences in survival among patients with urachal and nonurachal adenocarcinomas of the bladder. Cancer. 2006;107(4):721-728.
  14. Vanessa Monteiro, Teresa Margarida Cunha. Urachal carcinoma: imaging findings. Acta Radiologica Short reports. 2012;1:4.
  15. Gopalan A., Sharp D.S., Fine S.W. et al. Urachal carcinoma: a clinicopathologic analisys of 24 cases with outcome correlation. American Journal of surgical pathology. 2009;5:659-668.
  16. Richard A. Ashley, Brant A. Inman, Jonathan C. Routh, et al. Urachal Anomalies: A Longitudinal Study of Urachal Remnants in Children and Adults. The Journal of Urology. 2007;178(4):1615-1618.
  17. Cacciarelli A.A., Kass J.E., Yang S.S. Urachal remnants: Sonographic demonstration in children. Radiology. 1990;174:473-475.
  18. Zieger B., Sokol B., Rohrschneider W. Sonomorphology and involution of the normal urachus in asymptomatic newborns. Pediatr Radiol. 1998;28:156-161.
  19. Ozbek S.S., Pourbagher M.A., Pourbagher A. Urachal remnants in asymptomatic children: gray-scale and color Doppler sonographic findings. J. Clin. Ultrasound. 2001;29(4):218-222.
  20. Бабаян А. Б. Урахус и его заболевания. Афтореф. дис. канд. мед. наук. Ташкентский Государственный Медицинский Институт. 1963. 18 с.
  21. Robert Y., Hennequin-Delerue C., Chaillet D. Urachal remnants: Sonographic assessment. J Clin Ultrasound. 1996;24:339-344.
  22. Blichert-Toft M., Koch F., Nielsen O.V. Anatomic variants of the urachus related to clinical appearance and surgical treatment of urachal lesions. Surgical Gynecology. 1973;137:51.
  23. Yu H., Leong L.H. Carcinoma of the urachus: Report of one case and review of literature. Surgery. 1975;77:726-729.
  24. Upadhyay V., Kukkady A. Urachal remnants: an enigma. European Journal of Pediatric Surgery. 2003;13:372-376.
  25. Pinthus J., Haddad R., Trachtenberg J. Populaption based survival data on urachal tumors. Journal of Urology. 2006;175:2042-2047.
  26. Scabini S., Rimini E. Urachal tumor: case report of a poorly understood carcinoma. World Journal of surgical oncology. 2009;7:29-32.
  27. Ghazizadeh M., Yamamoto S. Clinical features of urachal carcinoma in japan review of 157 patients. Urological research. 1983;11:235-238.
  28. Enid G.-B., Raj P. Kapur. Potter’s pathology of fetus, infant and child. Second edition, на англ.яз. Elsevier, 2007. P. 326-328.
  29. Aylward P., Samson K., Raynor S., Cusick R. Operative management ofurachal remnants: An NSQIP based study of postoperative complications. J Pediatr Surg. 2020;55(5):873-877.
  30. Stopak J.K., Azarow K.S. et al. Trends in surgical management of urachal anomalies. J Pediatr Surg. 2015;50(8):1334-1337.
  31. Dethlefs C.R., Abdessalam S.F. et al. Conservative management of urachal anomalies. J Pediatr Surg. 2019;54(5):1054-1058.
  32. McCollum M., MacNelly A., BBlair G. Surgical implications of urachal remnants: presentation and management. Journal of pediatric surgery. 2003;38:798-803.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies