Mora-Guzmán Ismael, Muñoz de Nova José Luis, Martín-Pérez Elena
Department of General and Digestive Surgery, Hospital Universitario de la Princesa , Madrid , SPAIN.
Acta Chir Belg. 2019 Oct;119(5):277-281. doi: 10.1080/00015458.2018.1503391. Epub 2018 Sep 27.
Management of asymptomatic Meckel's diverticulum (MD) incidentally discovered in adults remains controversial. The aim of this study was to determine if incidental diverticula should be removed. We reviewed a consecutive series of patients surgically managed from January 1994 to December 2016. Patients were divided into two groups according to symptomatic or asymptomatic diverticula, and characteristics were compared. The study included 66 patients: 30 in the symptomatic group (45%) and 36 in the incidental group (55%). We found 12 females (18.2%), and the ratio male:female was higher in the symptomatic group (14:1 vs. 2.6:1). Patients in the symptomatic group were significantly younger: 41.7 ± 18.1 vs. 54.7 ± 19.8 years ( = .007). MD in the symptomatic group tended to be longer (3.8 ± 1.9 vs. 2.6 ± 0.9 cm; = .003). A MD-associated malignancy was present in three patients (4.5%), all neuroendocrine tumours. Major postoperative complications occurred in 6.6% of symptomatic patients and 0% within the incidental group, without specific morbidity related to prophylactic surgery. No mortality was observed. Resection of incidentally found Meckel's diverticulum can be made because of benefits outweigh the risks in this high-risk area for cancer.
成人偶然发现的无症状梅克尔憩室（MD）的管理仍存在争议。本研究的目的是确定偶然发现的憩室是否应予以切除。我们回顾了1994年1月至2016年12月接受手术治疗的一系列连续患者。根据憩室有无症状将患者分为两组，并比较其特征。该研究包括66例患者：有症状组30例（45%），偶然发现组36例（55%）。我们发现12例女性（18.2%），有症状组的男女比例更高（14:1比2.6:1）。有症状组的患者明显更年轻：41.7±18.1岁对54.7±19.8岁（P = 0.007）。有症状组的MD往往更长（3.8±1.9比2.6±0.9 cm；P = 0.003）。3例患者（4.5%）存在与MD相关的恶性肿瘤，均为神经内分泌肿瘤。有症状患者术后主要并发症发生率为6.6%，偶然发现组为0%，且无与预防性手术相关的特定发病率。未观察到死亡病例。由于在这个癌症高危区域益处大于风险，因此可以对偶然发现的梅克尔憩室进行切除。
