Incidentally detected Meckel diverticulum: to resect or not to resect?
Ann Surg
; 247(2): 276-81, 2008 Feb.
Article
em En
| MEDLINE
| ID: mdl-18216533
ABSTRACT
BACKGROUND:
Management of incidentally detected Meckel diverticulum (MD) remains controversial. Our aims were to establish (1) the prevalence of MD; (2) the morbidity and (3) mortality due to MD.METHODS:
Systematic review A total of 244 papers meeting defined criteria were included; there were no prospective or randomized studies. MD prevalence and mortality from autopsy studies, postoperative complications, and outcome of incidentally detected MD were extracted. Population-based data Data were obtained from national databases on MD as cause of death, and on number of MD resections per year.RESULTS:
The prevalence of MD is 1.2% and historical mortality of MD was 0.01%. The current mortality from MD is 0.001%. The number of MD resections per year per 100,000 population decreased significantly after the pediatric age range (P < 0.001). Resection of incidentally detected MD has a significantly higher postoperative complication rate than leaving it in situ (P < 0.0001). The long-term outcome of patients with incidentally detected MD left in situ showed no complications. Seven-hundred fifty-eight patients would require incidentally detected MD resection to prevent 1 death from MD.CONCLUSIONS:
MD is present in 1.2% of the population, it is a very rare cause of mortality, and it is primarily a disease of the young. Leaving an incidentally detected MD in situ reduces the risk of postoperative complications without increasing late complications. A large number of MD resections would need to be performed to prevent 1 death from MD. The above evidence does not support the resection of incidentally detected MD.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tomada de Decisões
/
Laparotomia
/
Divertículo Ileal
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Ann Surg
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Reino Unido