Suppr超能文献

梅克尔憩室微创手术的临床结局:一项多中心研究。

Clinical outcomes of minimally invasive surgery for Meckel diverticulum: a multicenter study.

作者信息

Jung Hong Sub, Park Jun Ho, Yoon Sang Nam, Kang Byung Mo, Oh Bo Young, Kim Jong Wan

机构信息

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.

出版信息

Ann Surg Treat Res. 2020 Oct;99(4):213-220. doi: 10.4174/astr.2020.99.4.213. Epub 2020 Sep 24.

Abstract

PURPOSE

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.

METHODS

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).

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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)。

结果

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。

结论

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。

相似文献

1
Clinical outcomes of minimally invasive surgery for Meckel diverticulum: a multicenter study.
Ann Surg Treat Res. 2020 Oct;99(4):213-220. doi: 10.4174/astr.2020.99.4.213. Epub 2020 Sep 24.
2
Outcomes of laparoscopic resection of Meckel's diverticulum are equivalent to open laparotomy.
J Pediatr Surg. 2019 Mar;54(3):507-510. doi: 10.1016/j.jpedsurg.2018.03.010. Epub 2018 Mar 15.
3
Minimally invasive surgery as a treatment option for gastric cancer with liver metastasis: a comparison with open surgery.
Surg Endosc. 2018 Mar;32(3):1422-1433. doi: 10.1007/s00464-017-5826-0. Epub 2017 Oct 26.
6
[Application of laparoscopic and open gastrectomy in enhanced recovery after surgery for gastric cancer: analysis of data from multiple centers in China].
Nan Fang Yi Ke Da Xue Xue Bao. 2021 Dec 20;41(12):1828-1834. doi: 10.12122/j.issn.1673-4254.2021.12.11.
7
Laparoscopic approach to Meckel's diverticulum.
World J Gastroenterol. 2014 Jul 7;20(25):8173-8. doi: 10.3748/wjg.v20.i25.8173.
8
Minimally invasive surgery for remnant gastric cancer: a comparison with open surgery.
Surg Endosc. 2014 Aug;28(8):2452-8. doi: 10.1007/s00464-014-3496-8. Epub 2014 Mar 13.
9
Laparoscopic Colectomy for Acute Diverticulitis in the Urgent Setting is Associated with Similar Outcomes to Open.
Am Surg. 2022 May;88(5):901-907. doi: 10.1177/00031348211054553. Epub 2021 Nov 2.
10
"Fast-track" and "Minimally Invasive" Surgery for Gastric Cancer.
Chin Med J (Engl). 2016 Oct 5;129(19):2294-300. doi: 10.4103/0366-6999.190659.

引用本文的文献

1
Meckel's diverticulum: analysis of 27 cases in an adult population.
Front Surg. 2023 Dec 18;10:1327545. doi: 10.3389/fsurg.2023.1327545. eCollection 2023.
3
Meckel's diverticulum abscess in the elderly population: A case report.
Ann Med Surg (Lond). 2022 Jan 26;74:103317. doi: 10.1016/j.amsu.2022.103317. eCollection 2022 Feb.

本文引用的文献

1
Outcomes of laparoscopic resection of Meckel's diverticulum are equivalent to open laparotomy.
J Pediatr Surg. 2019 Mar;54(3):507-510. doi: 10.1016/j.jpedsurg.2018.03.010. Epub 2018 Mar 15.
2
Intussusception due to an Inverted Meckel's Diverticulum Diagnosed by Double-Balloon Enteroscopy.
Case Rep Gastroenterol. 2017 Oct 30;11(3):632-636. doi: 10.1159/000481161. eCollection 2017 Sep-Dec.
3
Meckel diverticulum in exomphalos minor.
Ann Surg Treat Res. 2016 Aug;91(2):90-2. doi: 10.4174/astr.2016.91.2.90. Epub 2016 Jul 21.
4
Vitellointestinal Duct Anomalies in Infancy.
J Neonatal Surg. 2016 Jul 3;5(3):30. doi: 10.21699/jns.v5i3.351. eCollection 2016 Jul-Sep.
5
Laparoscopic vs. laparoscopically assisted management of Meckel's diverticulum in children.
Int J Clin Exp Med. 2015 Jan 15;8(1):94-100. eCollection 2015.
6
Laparoscopic approach to Meckel's diverticulum.
World J Gastroenterol. 2014 Jul 7;20(25):8173-8. doi: 10.3748/wjg.v20.i25.8173.
7
Radiologist's perspective for the Meckel's diverticulum and its complications.
Br J Radiol. 2014 May;87(1037):20130743. doi: 10.1259/bjr.20130743. Epub 2014 Feb 17.
8
Clinical Features of Symptomatic Meckel's Diverticulum in Children: Comparison of Scintigraphic and Non-scintigraphic Diagnosis.
Pediatr Gastroenterol Hepatol Nutr. 2013 Mar;16(1):41-8. doi: 10.5223/pghn.2013.16.1.41. Epub 2013 Mar 31.
9
Single-incision laparoscopic surgery in diagnosis and treatment for gastrointestinal bleeding of obscure origin in children.
Surg Laparosc Endosc Percutan Tech. 2013 Jun;23(3):e106-8. doi: 10.1097/SLE.0b013e3182806517.
10
Perforation of Meckel's diverticulum by an intact fish bone.
BMJ Case Rep. 2013 Feb 20;2013:bcr2012008226. doi: 10.1136/bcr-2012-008226.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验