Jung Hong Sub, Park Jun Ho, Yoon Sang Nam, Kang Byung Mo, Oh Bo Young, Kim Jong Wan
Department of Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Ann Surg Treat Res. 2020 Oct;99(4):213-220. doi: 10.4174/astr.2020.99.4.213. Epub 2020 Sep 24.
Meckel diverticulum (MD), caused by an obliteration defect of the omphalomesenteric duct, is one of the most common congenital anomalies of small intestines. The objective of this study was to review surgical outcomes of MD and evaluate the feasibility of minimally invasive surgery (MIS) in MD.
We performed a retrospective analysis of the medical records of patients who underwent diverticulectomy for MD at 6 Hallym University-affiliated hospitals between January 2008 and December 2017. All patients underwent either open surgery or MIS. Patients who underwent MIS were subdivided into laparoscopic only diverticulectomy (LOD) or laparoscopic-assisted diverticulectomy (LAD).
Of 64 patients, 21 underwent open surgery and 43 underwent MIS. Time to flatus, time to soft food intake, and length of hospital stay were shorter in the MIS group than in the open surgery group (P = 0.047, P = 0.005, and P = 0.015, respectively). Among patients who underwent MIS, the time to flatus and time to soft food intake were longer in the LAD group than in the LOD group (0.3 and 0.9 days, respectively). Multivariate analysis showed that old age and preoperative ileus were independent predictors of complications (P = 0.030 and P = 0.013, respectively). Operation type (open surgery, LOD, or LAD) was not associated with complications.
The present study showed that MIS is associated with quicker recovery without increasing complications. Therefore, MIS may be a safe alternative to open surgery for MD. An old age and preoperative ileus were associated with a risk of postoperative complications.
梅克尔憩室(MD)由卵黄管闭塞缺陷引起,是小肠最常见的先天性异常之一。本研究的目的是回顾MD的手术结果,并评估微创手术(MIS)在MD治疗中的可行性。
我们对2008年1月至2017年12月期间在6家韩林大学附属医院接受MD憩室切除术的患者的病历进行了回顾性分析。所有患者均接受开放手术或MIS。接受MIS的患者又分为单纯腹腔镜憩室切除术(LOD)或腹腔镜辅助憩室切除术(LAD)。
64例患者中,21例接受开放手术,43例接受MIS。MIS组的排气时间、开始进食软食时间和住院时间均短于开放手术组(分别为P = 0.047、P = 0.005和P = 0.015)。在接受MIS的患者中,LAD组的排气时间和开始进食软食时间比LOD组长(分别为0.3天和0.9天)。多因素分析显示,高龄和术前肠梗阻是并发症的独立预测因素(分别为P = 0.030和P = 0.013)。手术类型(开放手术、LOD或LAD)与并发症无关。
本研究表明,MIS可使患者恢复更快且不增加并发症。因此,MIS可能是MD开放手术的一种安全替代方法。高龄和术前肠梗阻与术后并发症风险相关。