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Clinical outcomes of minimally invasive surgery for Meckel diverticulum: a multicenter study

Annals of Surgical Treatment and Research 2020년 99권 4호 p.213 ~ 220
정홍섭, 박준호, 윤상남, 강병모, 오보영, 김종완,
소속 상세정보
정홍섭 ( Jung Hong-Sub ) - Hallym University College of Medicine Dongtan Sacred Heart Hospital Department of Surgery
박준호 ( Park Jun-Ho ) - Hallym University College of Medicine Kangdong Sacred Heart Hospital Department of Surgery
윤상남 ( Yoon Sang-Nam ) - Hallym University College of Medicine Kangnam Sacred Heart Hospital Department of Surgery
강병모 ( Kang Byung-Mo ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Surgery
오보영 ( Oh Bo-Young ) - Hallym University College of Medicine Hallym University Sacred Heart Hospital Department of Surgery
김종완 ( Kim Jong-Wan ) - Hallym University College of Medicine Dongtan Sacred Heart Hospital Department of Surgery

Abstract


Purpose: Meckel diverticulum (MD), caused by an obliteration defect of the omphalomesenteric duct, is one of the most common congenital anomalies of small intestines. The objective of this study was to review surgical outcomes of MD and evaluate the feasibility of minimally invasive surgery (MIS) in MD.

Methods: We performed a retrospective analysis of the medical records of patients who underwent diverticulectomy for MD at 6 Hallym University-affiliated hospitals between January 2008 and December 2017. All patients underwent either open surgery or MIS. Patients who underwent MIS were subdivided into laparoscopic only diverticulectomy (LOD) or laparoscopic-assisted diverticulectomy (LAD).

Results: Of 64 patients, 21 underwent open surgery and 43 underwent MIS. Time to flatus, time to soft food intake, and length of hospital stay were shorter in the MIS group than in the open surgery group (P = 0.047, P = 0.005, and P = 0.015, respectively). Among patients who underwent MIS, the time to flatus and time to soft food intake were longer in the LAD group than in the LOD group (0.3 and 0.9 days, respectively). Multivariate analysis showed that old age and preoperative ileus were independent predictors of complications (P = 0.030 and P = 0.013, respectively). Operation type (open surgery, LOD, or LAD) was not associated with complications.

Conclusion: The present study showed that MIS is associated with quicker recovery without increasing complications. Therefore, MIS may be a safe alternative to open surgery for MD. An old age and preoperative ileus were associated with a risk of postoperative complications.

키워드

Laparoscopic surgery; Laparoscopy; Meckel diverticulum

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