Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2021; 9(36): 11228-11236
Published online Dec 26, 2021. doi: 10.12998/wjcc.v9.i36.11228
Surgical perspectives of symptomatic omphalomesenteric duct remnants: Differences between infancy and beyond
Ayoung Kang, Soo-Hong Kim, Yong-Hoon Cho, Hae-Young Kim
Ayoung Kang, Soo-Hong Kim, Hae-Young Kim, Department of Surgery, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
Yong-Hoon Cho, Department of Surgery, Pusan National University School of Medicine, Yangsan 50612, South Korea
Yong-Hoon Cho, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
Author contributions: Cho YH and Kim SH conceptualized this study; Kang A, Kim SH, and Cho YH were involved in the study design, data collation, analysis, interpretation of results, and initial draft of manuscript; Kang A, Kim SH, Cho YH, and Kim HY reviewed the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Pusan National University Yangsan Hospital Institutional Review Board, No. 05-2020-111.
Informed consent statement: The requirement for informed consent was waived. This was a retrospective study. Therefore, it was impossible to get consent from patients and their guardians in advance. This study data did’t use data that could be used to identify the participants, and it may be published in a journal worthy of being open to the public after collecting data of treatments and operations for the past 12 years based on medical records only.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Hoon Cho, MD, PhD, Full Professor, Department of Surgery, Pusan National University School of Medicine, No. 49 Busandaehak-ro, Yangsan 50612, South Korea. choyh70@pusan.ac.kr
Received: June 21, 2021
Peer-review started: June 21, 2021
First decision: September 28, 2021
Revised: September 29, 2021
Accepted: November 14, 2021
Article in press: November 14, 2021
Published online: December 26, 2021
Processing time: 185 Days and 4.1 Hours
ARTICLE HIGHLIGHTS
Research background

The omphalomesenteric duct remnant (OMDR) shows variable clinical manifestations according to the age at diagnosis with a lifelong complication rates of 4-34 which more common in patients younger than 2 years of age.

Research motivation

Identify the distinct clinical features and its management according to different age groups.

Research objectives

Variant clinical types of OMDR according to pediatric age were assessed and its results were analyzed, then tried to suggest a useful information for proper management by figuring out surgical perspectives.

Research methods

A total of 35 patients (7 infants, 28 children beyond infancy) were reviewed. The patients were divided into two groups, infant and beyond infancy. The patients’ demographic characteristics, clinical manifestations, diagnostic tools, surgical procedures, and clinical outcomes were compared between two groups.

Research results

There were two different clinical patterns, Meckel's diverticulum (MD) was the most common clinical type and umbilical lesions were significantly common in the infant group (P = 0.006). Umbilical lesions were the most commonly presented symptom in infants, whereas hematochezia and abdominal pain were beyond infancy group. Meckel's scan was most useful in diagnosing OMDR in patients with painless rectal bleeding. Minimally invasive surgery (MIS), especially a single-incision laparoscopic surgery (SILS), was performed more frequently in children than infants (P = 0.016).

Research conclusions

Considering the different clinical types, umbilical lesions in infants and MD beyond infancy, a MIS is effective for managing MD regardless of age.

Research perspectives

SILS could be considered as a preferred method for managing OMDR regardless of age.