Department of Pediatric Surgery, Connecticut Children's Medical Center and University of Connecticut School of Medicine, Hartford, CT 06106, USA.
J Pediatr Surg. 2011 May;46(5):893-6. doi: 10.1016/j.jpedsurg.2011.02.024.
Treatment recommendations for Meckel's diverticulum (MD) come mostly from single-institution case series. The objective of this study was to review the surgical management and outcomes of children undergoing Meckel's diverticulectomy using contemporary data from a national database.
We queried 2007 to 2008 data from the Pediatric Health Information System database and analyzed demographic and outcome variables for patients undergoing surgical resection of MD. Cases were classified as primary (symptomatic MD) or secondary (incidental MD). Outcomes in primary cases were compared between open and laparoscopic approaches. Statistical analyses were performed using SPSS (Chicago, IL).
Eight hundred fifteen children underwent Meckel's diverticulectomy. Meckel's diverticulectomy was more common in boys (boy-girl, 2.3:1), and half (53%) of the children required surgery before their fourth birthday. More cases (n = 485; 60%) were classified as primary, and most children were approached by laparotomy (75%). The most common presentations for primary cases were obstruction (30%), bleeding (27%), and intussusception (19%). In the primary group, patients treated with the laparoscopic approach had a shorter length of stay (open approach, 5.7 ± 5.2 days; laparoscopic approach, 4.3 ± 2.7 days; P < .02).
These data describe current trends in the surgical treatment of MD in the United States. Laparoscopic Meckel's diverticulectomy appears to shorten length of stay but is used much less frequently than the traditional open approach.
梅克尔憩室（MD）的治疗建议主要来自单一机构的病例系列。本研究的目的是使用国家数据库中的当代数据，回顾接受梅克尔憩室切除术的儿童的手术治疗方法和结果。
我们查询了 2007 年至 2008 年小儿健康信息系统数据库的数据，并分析了接受 MD 手术切除的患者的人口统计学和结果变量。病例分为原发性（症状性 MD）或继发性（偶发性 MD）。原发性病例的开放式和腹腔镜方法的结果进行了比较。使用 SPSS（芝加哥，IL）进行统计分析。
815 名儿童接受了梅克尔憩室切除术。梅克尔憩室切除术在男孩中更为常见（男：女，2.3:1），一半（53%）的儿童在四岁生日之前需要手术。更多的病例（n=485；60%）被归类为原发性，大多数儿童采用剖腹手术（75%）。原发性病例最常见的表现为梗阻（30%）、出血（27%）和肠套叠（19%）。在原发性组中，接受腹腔镜治疗的患者住院时间更短（开放手术，5.7±5.2 天；腹腔镜手术，4.3±2.7 天；P<0.02）。
这些数据描述了美国目前 MD 手术治疗的趋势。腹腔镜梅克尔憩室切除术似乎可以缩短住院时间，但比传统的开放方法使用得少得多。
