Early Outcomes of Laparoscopic Versus Open Surgery for Urachal Remnant Resection in Children: A Retrospective Analysis Using a Nationwide Inpatient Database in Japan.

Background: There was no large study that assessed the surgical safety of laparoscopic surgery (LS) for urachal remnant resection. This study compared early postoperative outcomes between LS and open surgery (OS) for pediatric urachal remnant resection, using a national inpatient database. Patients and Methods: Using the Diagnosis Procedure Combination database in Japan, we compared postoperative complications, duration of anesthesia, postoperative length of stay, and total hospitalization cost between LS and OS for children undergoing urachal remnant surgery from April 2015 to March 2017. Propensity score-adjusted analyses were performed for outcomes. Results: Among 882 eligible patients (306 LS; 576 OS), there were no significant differences between LS and OS for postoperative complications (odds ratio: 1.02; 95% confidence interval [CI]: 0.48-2.18; P  = .96) and postoperative length of stay (difference: 0.14 day; 95% CI: -0.27 to 0.54; P  = .39). Compared with OS, LS had significantly longer duration of anesthesia (difference: 51 minutes; 95% CI: 42-60; P  < .001) and significantly higher total hospitalization cost (difference: US$824; 95% CI: 399-1249; P  < .001). Conclusions: In this large nationwide cohort study, LS for urachal remnant resection was associated with longer duration of anesthesia and higher total hospitalization cost. However, no differences were detected between LS and OS regarding postoperative complications and length of stay. LS for urachal remnant resection is equivalent to OS in terms of surgical safety.