title: The urachal pathology with umbilical manifestation: overview of laparoscopic technique.
abstract: BACKGROUND
  The persistent patency of the urachus after birth is a rare anomaly, especially because most of the cases are asymptomatic. The guiding symptom for urachal-umbilical sinus and urachal cyst is the presence of umbilical discharge. Even if today we tend to laparoscopic treatment, in scientific literature there is still no evidence, because the reports are rare and often they are clinical cases.
  
  
  METHODS
  Thirteen patients with a symptomatic urachal pathology were evaluated; 12 of these were affected by umbilical discharge and 1 by periumbilical discomfort. Five of 13 were prospectively treated by laparoscopy and the remaining 8 patients, who had been previously treated with conventional surgery, formed the control group. The authors report the laparoscopic technique used, which allowed the complete excision of the urachus.
  
  
  RESULTS
  The operation time was lower for the patients treated by conventional surgery (71.9 minutes versus 101 minutes; P=.002), whereas the control pain (P=.05) and, above all, the excised urachus length (11.6 versus 8.7 cm; P=.03) were in favor of the patients treated by laparoscopic surgery. We registered only one recurrence in a patient treated by conventional surgery.
  
  
  CONCLUSIONS
  In the rare international scientific literature, only one study report comparative data, as our study. The results that we obtained seem to be in favor of the laparoscopic procedure, although prospective, randomized trials are needed to get stronger evidence.
authors.affiliation: Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Catania, Italy. g.lidestri@unict.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Li Destri
authors.forename: Dario
authors.initials: D
authors.lastname: Schillaci
authors.forename: Rosalia
authors.initials: R
authors.lastname: Latino
authors.forename: Marine
authors.initials: M
authors.lastname: Castaing
authors.forename: Beniamino
authors.initials: B
authors.lastname: Scilletta
authors.forename: Antonio Di
authors.initials: AD
authors.lastname: Cataldo
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D014472:Umbilicus / Q000473:pathology / Q000601:surgery; D014497:Urachus / Q000002:abnormalities / Q000473:pathology* / Q000601:surgery