{"id":652,"date":"2017-12-16T16:16:19","date_gmt":"2017-12-16T16:16:19","guid":{"rendered":"http:\/\/www.drshevchuk.com.ua\/?p=652"},"modified":"2017-12-17T14:47:15","modified_gmt":"2017-12-17T14:47:15","slug":"management-of-asymptomatic-pediatric-umbilical-hernias-a-systematic-review-2","status":"publish","type":"post","link":"http:\/\/www.drshevchuk.com.ua\/?p=652","title":{"rendered":"Management of asymptomatic pediatric umbilical hernias: a systematic review\/ \u0412\u0435\u0434\u0435\u043d\u043d\u044f \u0431\u0435\u0437\u0441\u0438\u043c\u043f\u0442\u043e\u043c\u043d\u0438\u0445 \u0434\u0438\u0442\u044f\u0447\u0438\u0445 \u043f\u0443\u043f\u043e\u0447\u043d\u0438\u0445 \u0433\u0440\u0438\u0436: \u0441\u0438\u0441\u0442\u0435\u043c\u0430\u0442\u0438\u0447\u043d\u0438\u0439 \u043e\u0433\u043b\u044f\u0434"},"content":{"rendered":"<h2 class=\"sectionTitle\" style=\"text-align: justify;\" tabindex=\"0\">Abstract<\/h2>\n<h2 style=\"text-align: justify;\">\u0422\u0435\u0437\u0438<\/h2>\n<p style=\"text-align: justify;\">\n<div class=\"content expandedDiv\" style=\"text-align: justify;\">\n<section>\n<h3 class=\"sectionTitle\" tabindex=\"0\">Introduction<\/h3>\n<div class=\"content expandedDiv\">\n<p>Uncomplicated pediatric umbilical hernias are common and most close spontaneously. No formal practice guidelines exist regarding the optimal timing and indications for repair. The objective of this review is to examine the existing literature on the natural history of pediatric umbilical hernias, known complications of repair and non-operative approaches, and management recommendations.<\/p>\n<h3>\u0412\u0441\u0442\u0443\u043f.<\/h3>\n<p>\u041d\u0435 \u0443\u0441\u043a\u043b\u0430\u0434\u043d\u0435\u043d\u0456 \u0434\u0438\u0442\u044f\u0447\u0456 \u043f\u0443\u043f\u043e\u0447\u043d\u0456 \u0433\u0440\u0438\u0436\u0456 \u0434\u043e\u0441\u0438\u0442\u044c \u043f\u043e\u0448\u0438\u0440\u0435\u043d\u0456 \u0456 \u0443 \u0431\u0456\u043b\u044c\u0448\u043e\u0441\u0442\u0456 \u0432\u0438\u043f\u0430\u0434\u043a\u0456\u0432 \u0437\u0430\u043a\u0440\u0438\u0432\u0430\u044e\u0442\u044c\u0441\u044f \u0441\u043f\u043e\u043d\u0442\u0430\u043d\u043d\u043e. \u041f\u0440\u043e\u0442\u043e\u043a\u043e\u043b\u0438 \u0441\u0442\u043e\u0441\u043e\u0432\u043d\u043e \u0447\u0430\u0441\u0443 \u0445\u0456\u0440\u0443\u0440\u0433\u0456\u0447\u043d\u043e\u0457 \u043a\u043e\u0440\u0435\u043a\u0446\u0456\u0457 \u0442\u0430 \u043f\u043e\u043a\u0430\u0437\u0456\u0432 \u0434\u043e \u043d\u0435\u0457 \u043d\u0435 \u0456\u0441\u043d\u0443\u0454. \u041c\u0435\u0442\u0430 \u0446\u044c\u043e\u0433\u043e \u0434\u043e\u0441\u043b\u0456\u0434\u0436\u0435\u043d\u043d\u044f &#8211; \u0432\u0438\u0432\u0447\u0438\u0442\u0438 \u0434\u043e\u0441\u0442\u0443\u043f\u043d\u0443 \u043b\u0456\u0442\u0435\u0440\u0430\u0442\u0443\u0440\u0443 \u0441\u0442\u043e\u0441\u043e\u0432\u043d\u043e \u043d\u0435\u0443\u0441\u043a\u043b\u0430\u0434\u043d\u0435\u043d\u0438\u0445 \u043f\u0443\u043f\u043e\u0447\u043d\u0438\u0445 \u0433\u0440\u0438\u0436 \u0443 \u0434\u0456\u0442\u0435\u0439, \u043c\u043e\u0436\u043b\u0438\u0432\u0456 \u0443\u0441\u043a\u043b\u0430\u0434\u043d\u0435\u043d\u043d\u044f \u0445\u0456\u0440\u0443\u0440\u0433\u0456\u0447\u043d\u043e\u0433\u043e \u043b\u0456\u043a\u0443\u0432\u0430\u043d\u043d\u044f \u0442\u0430 \u043d\u0435 \u0445\u0456\u0440\u0443\u0440\u0433\u0456\u0447\u043d\u0456 \u043f\u0456\u0434\u0445\u043e\u0434\u0438, \u043d\u0430\u044f\u0432\u043d\u0456 \u0440\u0435\u043a\u043e\u043c\u0435\u043d\u0434\u0430\u0446\u0456\u0457.<\/p>\n<\/div>\n<\/section>\n<\/div>\n<div class=\"content expandedDiv\" style=\"text-align: justify;\">\n<section>\n<h3 class=\"sectionTitle\" tabindex=\"0\">Study design<\/h3>\n<div class=\"content expandedDiv\">\n<p>A systematic literature search was performed to identify publications relating to pediatric umbilical hernias. Inclusion criteria comprised studies addressing recommendations for optimal timing of repair, evidence examining complications from hernias not operatively repaired, and research exploring the likelihood of pediatric umbilical hernias to close spontaneously. In addition, the websites of all pediatric hospitals in the United States were examined for recommendations on operative timing.<\/p>\n<h3>\u0414\u0438\u0437\u0430\u0439\u043d \u0434\u043e\u0441\u043b\u0456\u0434\u0436\u0435\u043d\u043d\u044f<\/h3>\n<p>\u0421\u0438\u0441\u0442\u0435\u043c\u0430\u0442\u0438\u0447\u043d\u0438\u0439 \u043f\u043e\u0448\u0443\u043a \u043b\u0456\u0442\u0435\u0440\u0430\u0442\u0443\u0440\u0438 \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0432\u0441\u044f \u0437 \u043c\u0435\u0442\u043e\u044e \u0432\u0438\u0432\u0447\u0435\u043d\u043d\u044f \u043f\u0443\u0431\u043b\u0456\u043a\u0430\u0446\u0456\u0439 \u0441\u0442\u043e\u0441\u043e\u0432\u043d\u043e \u0434\u0438\u0442\u044f\u0447\u0438\u0445 \u043f\u0443\u043f\u043e\u0447\u043d\u0438\u0445 \u0433\u0440\u0438\u0436.\u041a\u0440\u0438\u0442\u0435\u0440\u0456\u044f\u043c\u0438 \u0432\u043a\u043b\u044e\u0447\u0435\u043d\u043d\u044f \u0443 \u043e\u0433\u043b\u044f\u0434 \u0431\u0443\u043b\u0438 \u0440\u0435\u043a\u043e\u043c\u0435\u043d\u0434\u0430\u0446\u0456\u0457 \u0434\u043e \u043b\u0456\u043a\u0443\u0432\u0430\u043d\u043d\u044f, \u0443\u0441\u043a\u043b\u0430\u0434\u043d\u0435\u043d\u043d\u044f \u0443 \u0432\u0438\u043f\u0430\u0434\u043a\u0443 \u0432\u0456\u0434\u0441\u0443\u0442\u043d\u043e\u0441\u0442\u0456 \u0445\u0456\u0440\u0443\u0440\u0433\u0456\u0447\u043d\u043e\u0433\u043e \u043b\u0456\u043a\u0443\u0432\u0430\u043d\u043d\u044f \u0442\u0430 \u0432\u0438\u0432\u0447\u0435\u043d\u043d\u044f \u043f\u0438\u0442\u0430\u043d\u043d\u044f \u043c\u043e\u0436\u043b\u0438\u0432\u043e\u0441\u0442\u0456 \u0441\u043f\u043e\u043d\u0442\u0430\u043d\u043d\u043e\u0433\u043e \u0432\u0438\u0440\u0456\u0448\u0435\u043d\u043d\u044f \u0441\u0438\u0442\u0443\u0430\u0446\u0456\u0457.<\/p>\n<\/div>\n<\/section>\n<\/div>\n<div class=\"content expandedDiv\" style=\"text-align: justify;\">\n<section>\n<h3 class=\"sectionTitle\" tabindex=\"0\">Results<\/h3>\n<div class=\"content expandedDiv\">\n<p>A total of 787 manuscripts were reviewed, and 28 met criteria for inclusion in the analysis. Studies examined the likelihood of spontaneous closure based on child&#8217;s age and size of hernia defect, complications of unrepaired umbilical hernias including incarceration, strangulation and evisceration based on child&#8217;s age and size of defect, incidence of postoperative complications and current recommendations for timing of repair. In addition, 63 (27.5%) of the United States pediatric hospital websites published a wide range of management recommendations.<\/p>\n<h3>\u0420\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u0438<\/h3>\n<p>\u0417\u0430\u0433\u0430\u043b\u043e\u043c 787 \u0441\u0442\u0430\u0442\u0435\u0439 \u0431\u0443\u043b\u043e \u043e\u0433\u043b\u044f\u043d\u0443\u0442\u043e.<\/p>\n<\/div>\n<\/section>\n<\/div>\n<div class=\"content expandedDiv\" style=\"text-align: justify;\">\n<section>\n<h3 class=\"sectionTitle\" tabindex=\"0\">Conclusion<\/h3>\n<div class=\"content expandedDiv\">\n<p>Despite the high prevalence of pediatric umbilical hernias, there is a paucity of high quality data to guide management. The literature does suggest that expectant management of asymptomatic hernias until age 4\u20135\u2005years, regardless of size of hernia defect, is both safe and the standard practice of many pediatric hospitals.<\/p>\n<\/div>\n<\/section>\n<\/div>\n<div class=\"content expandedDiv\" style=\"text-align: justify;\">\n<section>\n<h3 class=\"sectionTitle\" tabindex=\"0\">Type of study<\/h3>\n<div class=\"content expandedDiv\">\n<p>Review Article.<\/p>\n<p>\u0422\u0438\u043f \u0434\u043e\u0441\u043b\u0456\u0434\u0436\u0435\u043d\u043d\u044f<\/p>\n<p>\u041e\u0433\u043b\u044f\u0434\u043e\u0432\u0430 \u0441\u0442\u0430\u0442\u0442\u044f.<\/p>\n<\/div>\n<\/section>\n<\/div>\n<div class=\"content expandedDiv\">\n<section>\n<h3 class=\"sectionTitle\" style=\"text-align: justify;\" tabindex=\"0\">Level of evidence<\/h3>\n<div class=\"content expandedDiv\">\n<p style=\"text-align: justify;\">Level IV.<\/p>\n<p>\u0420\u0456\u0432\u0435\u043d\u044c \u0434\u043e\u043a\u0430\u0437\u043e\u0432\u043e\u0441\u0442\u0456<\/p>\n<p>\u0420\u0456\u0432\u0435\u043d\u044c \u0406V<\/p>\n<\/div>\n<\/section>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Abstract \u0422\u0435\u0437\u0438 Introduction Uncomplicated pediatric umbilical hernias are common and most close spontaneously. No formal practice guidelines exist regarding the optimal timing and indications for repair. The objective of this review is to examine the existing literature on the natural history of pediatric umbilical hernias, known complications of repair and non-operative approaches, and management recommendations. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[11],"tags":[],"_links":{"self":[{"href":"http:\/\/www.drshevchuk.com.ua\/index.php?rest_route=\/wp\/v2\/posts\/652"}],"collection":[{"href":"http:\/\/www.drshevchuk.com.ua\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.drshevchuk.com.ua\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.drshevchuk.com.ua\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.drshevchuk.com.ua\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=652"}],"version-history":[{"count":8,"href":"http:\/\/www.drshevchuk.com.ua\/index.php?rest_route=\/wp\/v2\/posts\/652\/revisions"}],"predecessor-version":[{"id":670,"href":"http:\/\/www.drshevchuk.com.ua\/index.php?rest_route=\/wp\/v2\/posts\/652\/revisions\/670"}],"wp:attachment":[{"href":"http:\/\/www.drshevchuk.com.ua\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=652"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.drshevchuk.com.ua\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=652"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.drshevchuk.com.ua\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=652"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}