Manejo laparoscópico de las anomalías sintomáticas del uraco
Laparoscopic management of symptomatic urachal anomalies
Germán Cruz-González*,a, Rodolfo Sánchez-Salasa, Rene Sotelo**,a, Rafael E. Sánchez-Salas
,1,a, Alexis Sánchez-Ismayela, Renata Sáncheza, Omaira Rodrígueza, Erasmo Sanabriaa
* Servicio de Urología. Hospital Universitario de Caracas, Universidad Central de Venezuela
** Centro de Cirugía Robótica y Mínimamente invasiva. Instituto Médico La Floresta. Caracas, Venezuela
a Servicio de Cirugía III. Servicio de Urología. Hospital Universitario de Caracas, Universidad Central de Venezuela. Centro de Cirugía Robótica y Mínimamente invasiva. Instituto Médico La Floresta. Caracas, Venezuela
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Hospital Universitario de Caracas, Universidad Central de Venezuela" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Centro de Cirugía Robótica y Mínimamente invasiva. Instituto Médico La Floresta. Caracas, Venezuela" "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Cirugía III. Servicio de Urología. Hospital Universitario de Caracas, Universidad Central de Venezuela. Centro de Cirugía Robótica y Mínimamente invasiva. Instituto Médico La Floresta. Caracas, Venezuela" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia autor: Dr. Rafael E. Sánchez-Salas Servicio de Urología. Hospital Universitario de Caracas. Universidad Central de Venezuela Caracas, Venezuela Fax: 058 212 265 84 82" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Laparoscopic management of symptomatic urachal anomalies" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec88879" "palabras" => array:3 [ 0 => "Anomalía del uraco" 1 => "Tratamiento" 2 => "Laparoscopia" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec88880" "palabras" => array:3 [ 0 => "Urachal anomalies" 1 => "Treatment" 2 => "Laparoscopy" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Las anomalías uracales son una patología poco frecuente, el tratamiento aceptado consiste en la resección del uraco en todo su trayecto con o sin resección parcial de la vejiga. Nuestro objetivo es actualizar nuestra experiencia en el tratamiento de anomalías sintomáticas del uraco mediante cirugía de mínimo acceso.</p> <span class="elsevierStyleSectionTitle">Pacientes y Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Entre los años 2001 y 2007 se operaron 14 pacientes con anomalías adquiridas sintomáticas del uraco en nuestra institución. Se utilizó una técnica de tres portales previamente descrita por los autores, mediante la cual se realiza abordaje de la cavidad abdominal, confirmación del diagnóstico clínico inicial y resección del uraco en todo su trayecto en sentido cráneo caudal hasta la vejiga. Los datos demográficos y operatorios fueron recolectados de manera prospectiva y el análisis se realizó retrospectivamente.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El tiempo quirúrgico promedio fue de 63 minutos (45, 110) con sangrado mínimo, sin casos de conversión y sin complicaciones asociadas a la técnica. La gran mayoría de los pacientes egresó durante las primeras 24 horas. En un tiempo promedio de seguimiento de 22 meses no se han reportado recurrencias de la patología uracal.</p> <span class="elsevierStyleSectionTitle">Conclusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La laparoscopia juega un importante papel en el manejo de las anomalías sintomáticas del uraco, ya que permite confirmar el diagnóstico clínico y realizar la resección del uraco de manera segura y eficaz, aportando las ya conocidas ventajas de la cirugía de mínimo acceso. Los estudios de evaluación preoperatoria son de poca utilidad en la confirmación de esta patología.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Acquired urachal anomalies are a rare pathology. Gold-standard treatment for this clinical situation remains the resection of the urachus in its entire tract with or without partial resection of the bladder. Our aim is to up-date authors ´s experience in the minimally invasive surgical treatment of acquired urachal disease.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">From 2001 to 2007, 14 patients were operated for acquired urachal disease at our institution. A three portal technique previously described by the authors was employed. The diagnosis of acquired uracal disease was confirmed in all cases and the resection of the urachus in its entire tract performed in cephalocaudal direction onto the bladder. Operative and demographic data was prospectively collected and analysis retrospectively performed.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Mean operative time was 63 minutes (45,110), minimal blood loss, and no conversions to open surgery or perioperative complications were verified. The majority of the patients were discharged in the first 24 hours. At a follow-up of 22 months no recurrences of urachal pathology recurrences have been verified.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Laparoscopy plays a significant role in the management of symptomatic urachus anomalies. It allows objective confirmation of clinical diagnosis and adequate resection of the urachus in a safe and efficient fashion, while providing the well-known advantages of minimally acces surgery. Preoperative evaluation work-up has minimal impact of therapeutical decision.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:24 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Urachal remnants in adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Berman" 1 => "B. Tolia" 2 => "E. Laor" 3 => "R. Reid" 4 => "S. Schweizerhof" 5 => "S. 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| 2021 Abril | 0 | 9 | 9 |
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| 2021 Febrero | 0 | 4 | 4 |
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| 2020 Agosto | 0 | 6 | 6 |
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| 2020 Mayo | 0 | 6 | 6 |
| 2020 Abril | 0 | 2 | 2 |
| 2020 Marzo | 0 | 8 | 8 |
| 2020 Febrero | 0 | 4 | 4 |
| 2020 Enero | 0 | 14 | 14 |
| 2019 Diciembre | 0 | 23 | 23 |
| 2019 Noviembre | 0 | 11 | 11 |
| 2019 Octubre | 0 | 13 | 13 |
| 2019 Septiembre | 0 | 11 | 11 |
| 2019 Agosto | 0 | 6 | 6 |
| 2019 Julio | 0 | 17 | 17 |
| 2019 Junio | 0 | 23 | 23 |
| 2019 Mayo | 0 | 50 | 50 |
| 2019 Abril | 0 | 46 | 46 |
| 2019 Marzo | 0 | 16 | 16 |
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| 2019 Enero | 0 | 7 | 7 |
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| 2018 Octubre | 0 | 12 | 12 |
| 2018 Septiembre | 0 | 2 | 2 |
| 2018 Agosto | 0 | 1 | 1 |
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| 2018 Febrero | 1 | 1 | 2 |
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| 2017 Noviembre | 3 | 7 | 10 |
| 2017 Octubre | 2 | 4 | 6 |
| 2017 Septiembre | 3 | 21 | 24 |
| 2017 Agosto | 4 | 8 | 12 |
| 2017 Julio | 0 | 3 | 3 |
| 2017 Junio | 3 | 8 | 11 |
| 2017 Mayo | 4 | 15 | 19 |
| 2017 Abril | 5 | 12 | 17 |
| 2017 Marzo | 13 | 30 | 43 |
| 2017 Febrero | 3 | 6 | 9 |
| 2017 Enero | 4 | 1 | 5 |
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| 2016 Noviembre | 39 | 9 | 48 |
| 2016 Octubre | 29 | 4 | 33 |
| 2016 Septiembre | 11 | 5 | 16 |
| 2016 Agosto | 12 | 5 | 17 |
| 2016 Julio | 9 | 1 | 10 |
| 2016 Junio | 18 | 16 | 34 |
| 2016 Mayo | 13 | 40 | 53 |
| 2016 Abril | 7 | 20 | 27 |
| 2016 Marzo | 8 | 38 | 46 |
| 2016 Febrero | 9 | 26 | 35 |
| 2016 Enero | 19 | 30 | 49 |
| 2015 Diciembre | 13 | 22 | 35 |
| 2015 Noviembre | 11 | 11 | 22 |
| 2015 Octubre | 20 | 13 | 33 |
| 2015 Septiembre | 17 | 6 | 23 |
| 2015 Agosto | 5 | 5 | 10 |
| 2015 Julio | 17 | 3 | 20 |
| 2015 Junio | 8 | 2 | 10 |
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| 2015 Abril | 8 | 8 | 16 |
| 2015 Marzo | 3 | 4 | 7 |
| 2015 Febrero | 2 | 3 | 5 |
| 2015 Enero | 4 | 6 | 10 |
| 2014 Diciembre | 7 | 11 | 18 |
| 2014 Noviembre | 5 | 1 | 6 |
| 2014 Octubre | 8 | 7 | 15 |
| 2014 Septiembre | 8 | 2 | 10 |
| 2014 Agosto | 8 | 3 | 11 |
| 2014 Julio | 10 | 3 | 13 |
| 2014 Junio | 4 | 6 | 10 |
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| 2014 Abril | 2 | 5 | 7 |
| 2014 Marzo | 1 | 3 | 4 |
| 2014 Febrero | 1 | 7 | 8 |
| 2014 Enero | 1 | 4 | 5 |
| 2013 Diciembre | 7 | 4 | 11 |
| 2013 Noviembre | 7 | 4 | 11 |
| 2013 Octubre | 3 | 9 | 12 |
| 2013 Septiembre | 5 | 11 | 16 |
| 2013 Agosto | 7 | 13 | 20 |
| 2013 Julio | 2 | 1 | 3 |
| 2009 Marzo | 467 | 0 | 467 |
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