Introduction: Umbilical hernia is a common pediatric disorder that pediatric surgeons are usually asked to manage. Most cases will be closed spontaneously during the first 4-5 years of life. Low number of studies regarding umbilical defects in children does not allow a definitive guideline to be drawn about their natural history, indications and optimal timing for repair. In this systematic review, we evaluated the existing literature where pediatric umbilical hernias are addressed in regards to watchful waiting versus recommendations on timing of operative repair and we compared our institutional results with current literature. Aim: The aim of our study is to review and evaluate the current guidelines in management of umbilical hernias in children and to compare the results with our experience in management of umbilical hernia in our institution. Methods: Online literature search for studies that published about umbilical hernias in pediatric using literature’s search of ACP Journal Club, Clinical Evidence, Dynamed, Cochran Controlled Trial Register (1945-2015), UpToDate, and PubMed. We reviewed the recommendations of these studies regarding conservative treatment, rule and time of surgery, complications, and its natural history trend to close spontaneously. We compared the literature results and recommendations to our institutional results. We also conducted a retrospective medical charts review of 520 children aged between 1 month and 14 years presented to our institution for surgical consultation for asymptomatic umbilical hernia between 2007 and 2017. We only included children with umbilical hernia who are less than 14 years old and without other associated disorders. Results: A Total of 7 studies that met the inclusion criteria were reviewed. These studies examined the possibilities of spontaneous closure of hernia defect in pediatric, incidence of complications from watchful waiting and current recommendations for surgery timing. In general, spontaneous resolution were unlikely to be seen beyond the age of 5 years. Our institutional results found that of 442 cases treated conservatively between 2007 and 2017, 85% are closed spontaneously by 1-5 years of age. Conclusion: There is minimal top-notch clinical data guiding pediatric surgeons on management protocols in regards to umbilical hernias in children. Current published studies and our institutional retrospective study recommend that conservative management of asymptomatic, uncomplicated umbilical hernias until age 4-5 years is both safe and practical.
Umbilical hernia, spontaneous closure, Herniorraphy, watchful waiting, spontaneous resolution.
Alternating in-source fragmentation with single-stage high-resolution mass spectrometry with high annotation confidence in non-targeted metabolomics.
Wasito H, Causon T, Hann S
Talanta. 2022; 236(): 122828
Corrigendum to "Data mining Raman microspectroscopic responses of cells to drugs in vitro using multivariate curve resolution-alternating least squares" [Talanta 208 (2020) 120386].
Perez-Guaita D, Quintas G, Farhane Z, Tauler R, Byrne HJ
Talanta. 2022; 236(): 122682
Honesty and Transparency, Indispensable to the Clinical Mission-Part II: How Communication and Resolution Programs Promote Patient Safety and Trust.
Brenner MJ, Hickson GB, Rushton CH, Prince MEP, Bradford CR, Boothman RC
Otolaryngologic clinics of North America. 2022; 55(1): 63-82
High-Resolution Kinematic Analysis of Root Gravitropic Bending Using RootPlot.
Bhat A, DePew CL, Monshausen GB
Methods in molecular biology (Clifton, N.J.). 2022; 2368(): 95-109
Imaging the Actin Cytoskeleton in Fixed Budding Yeast Cells.
Sing CN, Yang EJ, Higuchi-Sanabria R, Pon LA, Boldogh IR, Swayne TC
Methods in molecular biology (Clifton, N.J.). 2022; 2364(): 81-100