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Incidental Meckel's diverticulectomy in adults
J B Peoples1, E J Lichtenberger, M M Dunn
1Department of Surgery, Wright State University School of Medicine, Dayton, Ohio, USA.
Surgery
|October 1, 1995
Summary
Prophylactic Meckel's diverticulectomy in adults carries a higher risk of surgical complications (4.6% morbidity, 0.2% mortality) than leaving incidental Meckel's diverticula untreated. Therefore, incidental diverticulectomy should be abandoned.
Area of Science:
- Gastrointestinal Surgery
- Surgical Decision Making
- Diverticular Disease
Background:
- The necessity of incidental Meckel's diverticulectomy is debated due to varying complication risks.
- Some surgeons favor prophylactic removal, citing lower risks compared to indicated resections.
- Others argue the low risk of complications does not warrant routine prophylactic surgery.
Purpose of the Study:
- To evaluate the risks associated with incidental Meckel's diverticulectomy in adults.
- To compare the morbidity and mortality of incidental versus indicated Meckel's diverticulectomy.
- To inform surgical practice regarding the management of incidentally discovered Meckel's diverticula.
Main Methods:
- Retrospective review of adult Meckel's diverticulectomy cases across four hospitals (1989-1993).
- Decision analysis employed to compare risks of incidental resection versus indicated resection for complications.
- Inclusion of previously reported data to enhance the analysis.
Main Results:
- Incidental Meckel's diverticulectomy in 90 patients resulted in 2% morbidity and 0% mortality.
- Resection for diverticulum complications in 4 patients had 0% morbidity and mortality.
- Decision analysis indicated a 4.6% morbidity and 0.2% mortality risk for incidental resection versus 0.2% and 0.04% for symptomatic resection.
Conclusions:
- Incidental Meckel's diverticulectomy in adults is associated with significantly higher surgical risks.
- The potential benefits of prophylactic removal do not outweigh the increased risks.
- Routine incidental Meckel's diverticulectomy in adults should be discontinued.
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