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Laparoscopic vs. laparoscopically assisted management of Meckel's diverticulum in children
Xufei Duan1, Guogang Ye1, Hongqiang Bian1
1Department of General Surgery, The Children Hospital of Wuhan Wuhan 430016, China.
Insights
Laparoscopic surgery for Meckel
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Meckel's diverticulum (MD) is a common congenital anomaly.
- Symptomatic MD requires surgical intervention.
Purpose of the Study:
- To evaluate laparoscopic management of pediatric Meckel's diverticulum.
- To assess feasibility of laparoscopic vs. laparoscopically assisted resection based on MD subtype.
Main Methods:
- 55 symptomatic pediatric MD cases were classified laparoscopically into simple and complex types.
- Simple MD treated with laparoscopic diverticulectomy.
- Complex MD treated with laparoscopically assisted resection and anastomosis.
Main Results:
- Laparoscopically assisted surgery took significantly longer (54.57 ± 20.17 min) than laparoscopic-only surgery (38.85 ± 9.75 min).
- 54 of 55 patients were cured with no complications at 4-36 month follow-up.
- One case had a complication during exploration.
Conclusions:
- Laparoscopic and laparoscopically assisted surgery are safe and effective for pediatric Meckel's diverticulum.
- Tailoring surgical approach based on MD subtype improves outcomes.
- Minimally invasive techniques offer a feasible treatment option.
Abstract:
To investigate the management of Meckel's diverticulum in children and the feasibility of using laparoscopic and laparoscopically assisted Meckel's diverticulum resection and intestinal anastomosis according to the different subtypes classified laparoscopically. 55 symptomatic Meckel's diverticulum cases were classified into two categories, the simple and the complex types depending on Meckel's diverticulum appearance upon laparoscopic exploration. Forty-one cases of simple Meckel's diverticulum were treated with simple diverticulectomy during laparoscopy, and 14 cases of complicated Meckel's diverticulum were treated with laparoscopically assisted Meckel's diverticulum resection and intestinal anastomosis. The operation time for the laparoscopically assisted was significant longer than laparoscopic-only surgeries [45~123 min (54.57 ± 20.17min) vs 29~78min (38.85 ± 9.75 min)], P = 0.013. Among the 55 cases, Just one child with simple type MD during laparoscopic exploration, and presented a diverticulum with a base that was considered to be in the mesangial margin. The remaining 54 patients were cured, and follow-up for 4~36 months revealed that they did not present abdominal pain, and no hematochezia occurred as a complication. Surgery selection either laparoscopy only or transumbilical laparoscopically assisted intestinal resection and intestinal anastomosis by laparoscopic exploration for Meckel's diverticulum treatment, based on the type of Meckel's diverticulum in children, is safe, feasible, and effective.