Department of Surgery, 21638The University of Kansas, USA.
Am Surg. 2021 Jun;87(6):892-896. doi: 10.1177/0003134820954820. Epub 2020 Dec 7.
Meckel's diverticulum is a congenital abnormality often associated with the pediatric population. When seen in the adult population, management is controversial. This study sought to determine demographic and outcome differences between diverticulectomy and small bowel resection in adults diagnosed with Meckel's diverticulum.
An analysis of the American College of Surgeons National Surgical Quality Improvement database (2015-2018) was performed, capturing patients with a postoperative diagnosis of Meckel's diverticulum. Inclusion criteria included diverticulectomy or small bowel resection, and exclusion criteria included other major procedures such as colectomy or concomitant diverticulectomy and a small bowel resection. Demographics and outcomes were analyzed between those receiving diverticulectomy or resection.
506 patients undergoing surgical treatment of Meckel's diverticulum were captured. The majority of these patients were white (79.05%), male (68.77%), and averaged 46 years old. The 2 populations were homogenous, with no significant differences in demographics or comorbidities between populations. Mean operative time was shorter in the diverticulectomy group than the resection group (68.92 ± 35.89 vs. 89.33 ± 40.16 minutes, < .0001). There were no deaths at 30 days. Length of stay, readmission rate, wound infection, and discharge destination were similar among both groups.
Our analysis of a national database reveals no difference in outcomes between patients receiving a diverticulectomy or resection for Meckel's diverticulum. Operating time may be slightly increased for resection. However, decision to excise the diverticulum vs. the segment of small bowel should be individualized to each patient, their pathology, and clinical picture.
梅克尔憩室是一种常与儿科人群相关的先天性异常。在成年人群中发现时，其治疗存在争议。本研究旨在确定诊断为梅克尔憩室的成人患者行憩室切除术与小肠切除术之间的人口统计学和结局差异。
对美国外科医师学会国家外科质量改进数据库（2015-2018 年）进行了分析，该数据库捕获了术后诊断为梅克尔憩室的患者。纳入标准包括行憩室切除术或小肠切除术，排除标准包括其他主要手术，如结肠切除术或同时行憩室切除术和小肠切除术。分析了接受憩室切除术或切除术的患者的人口统计学和结局。
共捕获了 506 例接受手术治疗梅克尔憩室的患者。这些患者大多数为白人（79.05%）、男性（68.77%），平均年龄为 46 岁。这两个群体具有同质性，在人口统计学和合并症方面，两个群体之间没有显著差异。憩室切除术组的手术时间明显短于切除术组（68.92±35.89 分钟 vs. 89.33±40.16 分钟，<.0001）。30 天内无死亡病例。两组的住院时间、再入院率、伤口感染和出院去向相似。
我们对国家数据库的分析显示，接受憩室切除术或切除术治疗梅克尔憩室的患者的结局无差异。切除术的手术时间可能略有增加。然而，切除憩室与切除小肠的节段应根据每个患者的病理和临床表现个体化决定。
