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Meckel's diverticulectomy: a multi-centre 19-year retrospective study.
Kevin Tree1,2, Krishna Kotecha1, Jenna Reeves1
1Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.
ANZ Journal of Surgery
|February 23, 2023
Summary
Meckel's diverticulectomy is a safe surgical option for Meckel's diverticulum (MD), showing fewer complications than bowel resection (BR). Resection strategy does not impact outcomes, even with higher perforation risks in certain MD shapes.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Abdominal Surgery
Background:
- Meckel's diverticulum (MD) presents acute surgical issues, often requiring resection of ectopic tissue.
- Traditional treatment involved bowel resection (BR), but Meckel's diverticulectomy is increasingly recognized as safe.
Purpose of the Study:
- To determine the optimal surgical resection strategy for MD.
- To assess MD histopathological features and their correlation with patient outcomes.
Main Methods:
- A 19-year retrospective review of 160 patients undergoing MD resection across seven hospitals.
- Data collected included demographics, clinical details, and pathology; statistical analysis used t-tests, chi-squared tests, and univariate regression.
Main Results:
- Meckel's diverticulectomy (70 patients) had fewer complications than BR (90 patients).
- MD perforation occurred in 15.3% of cases, with some containing ectopic gastric or carcinoid tissue.
- A greater MD length:width ratio was a risk factor for perforation (OR 1.437, P=0.042) but not malignancy or ectopic tissue.
Conclusions:
- Meckel's diverticulectomy, whether open or laparoscopic, is a safe alternative to BR for MD.
- Despite potential for perforation in elongated MD, diverticulectomy is supported as a safe approach without increased risk of malignancy or ectopic tissue.
