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有症状的梅克尔憩室的临床特征及治疗结果:儿童、青少年和成年患者的比较研究

Clinical characteristics and treatment outcomes of symptomatic Meckel diverticulum: a comparative study among children, adolescent, and adult patients.

作者信息

Park In Kyu, Cho Min Jeng

机构信息

Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

出版信息

Ann Surg Treat Res. 2023 Aug;105(2):107-113. doi: 10.4174/astr.2023.105.2.107. Epub 2023 Aug 1.

Abstract

PURPOSE

We investigated the clinical characteristics and treatment outcomes of symptomatic Meckel diverticulum (MD) in adolescents by comparison with children and adults.

METHODS

We retrospectively reviewed the medical records of patients who underwent symptomatic MD surgery from January 2002 to December 2019. Demographic information, clinical presentations, preoperative evaluations, operative variables, postoperative outcomes, and pathologic findings were collected. We performed analyses by dividing all patients into three groups according to age at surgery: child group (<10 years), adolescent group (10-19 years), and adult group (≥20 years).

RESULTS

Forty-three patients underwent symptomatic MD surgery (the child group, 14; the adolescent group, 17; and the adult group, 12). Vomiting and intestinal obstruction decreased significantly with age (P = 0.042 and 0.001), whereas hematochezia and gastrointestinal bleeding showed an increasing trend with age, although not statistically significant (P = 0.064 and 0.064). Ultrasound performance decreased significantly with age (P = 0.002), whereas CT performance showed an increasing trend with age, although not statistically significant (P = 0.193). Preoperative diagnosis rate increased significantly with age (P = 0.029). Laparoscopic surgery was performed significantly more in the adult group than in other groups (P = 0.001). The sizes of MD were significantly greater in the adolescent group than in other groups (P = 0.006 and 0.002).

CONCLUSION

The clinical characteristics and treatment outcomes of symptomatic MD in adolescents exhibit a transitional pattern between children and adults. Therefore, it is important for clinicians to recognize that adolescent patients with symptomatic MD have the characteristics of both children and adult patients to ensure optimal care.

摘要

目的

通过与儿童和成人进行比较,我们研究了青少年有症状梅克尔憩室(MD)的临床特征和治疗结果。

方法

我们回顾性分析了2002年1月至2019年12月期间接受有症状MD手术患者的病历。收集了人口统计学信息、临床表现、术前评估、手术变量、术后结果和病理检查结果。我们根据手术时的年龄将所有患者分为三组进行分析:儿童组(<10岁)、青少年组(10 - 19岁)和成人组(≥20岁)。

结果

43例患者接受了有症状MD手术(儿童组14例;青少年组17例;成人组12例)。呕吐和肠梗阻随年龄显著减少(P = 0.042和0.001),而便血和胃肠道出血随年龄呈上升趋势,尽管无统计学意义(P = 0.064和0.064)。超声检查的效能随年龄显著降低(P = 0.002),而CT检查的效能随年龄呈上升趋势,尽管无统计学意义(P = 0.193)。术前诊断率随年龄显著提高(P = 0.029)。成人组腹腔镜手术的实施显著多于其他组(P = 0.001)。青少年组MD的大小显著大于其他组(P = 0.006和0.002)。

结论

青少年有症状MD的临床特征和治疗结果呈现出儿童和成人之间的过渡模式。因此,临床医生认识到有症状MD的青少年患者具有儿童和成人患者的特征以确保最佳治疗很重要。

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本文引用的文献

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Complicated Meckel's diverticulum: Presentation modes in adults.复杂型梅克尔憩室:成人的表现形式
Medicine (Baltimore). 2018 Sep;97(38):e12457. doi: 10.1097/MD.0000000000012457.
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Meckel's Diverticulum in Adults: Surgical Concerns.成人梅克尔憩室:手术相关问题
Front Surg. 2018 Sep 3;5:55. doi: 10.3389/fsurg.2018.00055. eCollection 2018.

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