Laparoscopic management of Müllerian duct remnants in the paediatric age: Evidence and outcome analysis
| Autor: | Amulya Kumar Saxena, Maja Raicevic |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Intraoperative Complication medicine.medical_treatment 030232 urology & nephrology lcsh:Surgery Unilateral cryptorchidism outcomes Müllerian duct remnants 03 medical and health sciences 0302 clinical medicine children medicine Orchiopexy lcsh:RC799-869 Laparoscopy Hydronephrosis medicine.diagnostic_test business.industry lcsh:RD1-811 medicine.disease Surgery Hypospadias 030220 oncology & carcinogenesis Agenesis laparoscopy techniques lcsh:Diseases of the digestive system. Gastroenterology Original Article Incarcerated Inguinal Hernia business |
| Zdroj: | Journal of Minimal Access Surgery Journal of Minimal Access Surgery, Vol 14, Iss 2, Pp 95-98 (2018) |
| ISSN: | 1998-3921 0972-9941 |
| Popis: | Background: This study performed a literature analysis to determine outcomes of laparoscopic management in Mullerian duct remnants (MDRs). Patients and Methods: Literature was searched for terms 'Mullerian' 'duct' 'remnants' and 'laparoscopy'. Primary end points were age at surgery, laparoscopic technique, intraoperative complications and postoperative morbidity. Results: The search revealed 10 articles (2003–2014) and included 23 patients with mean age of 1.5 years (0.5–18) at surgery. All patients were 46XY, n = 1 normal male karyotype with two cell lines. Explorative laparoscopy was performed in n = 2 and surgical management in n = 21. The 5-port technique was used in n = 10, 3-port in n = 9 and robot-assisted laparoscopic approach in n = 1 (n = 1 technique not described). Complete MDRs removal in n = 9, complete dissection and MDRs neck ligation with endoscopic loops in n = 11 and n = 1 uterus and cervix were split in the midline. After MDRs removal, there were n = 2 bilateral orchidopexy, n = 3 unilateral orchidopexy, n = 1 Fowler–Stephens stage-I and n = 1 orchiectomy. Mean operative time was 193 min (120–334), and there were no intraoperative complications. Mean follow-up was 20.5 months (3–54) and morbidity included 1 prostatic diverticula. There were 13 associations with hypospadias, of which 3 had mixed gonads and 3 bilateral cryptorchidism. Other associations were unilateral cryptorchidism and incarcerated inguinal hernia n = 1, right renal agenesis and left hydronephrosis n = 1 and n = 2 with transverse testicular ectopy. Conclusion: This MDRs analysis suggests that the laparoscopic approach is an effective and safe method of treatment as no intraoperative complication has reported, and there is low morbidity in the long-term follow-up. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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