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Semptomatik ve İnsidental Meckel Divertiküllerinde Uygulanan Divertikülektominin Postoperatif Komplikasyonlarının Karşılaştırılması

Year 2022, Volume: 1 Issue: 1, 1 - 6, 25.06.2022

Abstract

Amaç: Erişkinlerde insidental saptanan Meckel divertikülünün (MD) yönetimi tartışmalıdır. Bu çalışmanın amacı, insidental ve semptomatik MD’de uygulanan divertikülektominin postoperatif komplikasyonlarının karşılaştırılmasıdır. Gereç ve Yöntemler: Kliniğimizde Ocak 2010-Aralık 2020 arasında cerrahi olarak tedavi edilen erişkin MD saptanan hastaların dosyaları incelendi. Hastalar semptomatik ve insidental divertiküllere sahip olmalarına göre iki gruba ayrıldı. Gruplar arasında yaş, cinsiyet, preoperatif laboratuvar değerleri, histopatoloji, hastanede kalış süresi ve postoperatif  komplikasyonlar karşılaştırıldı. Bulgular: Çalışmaya semptomatik (Grup 1,%78,3) ve insidental (Grup 2,%21,7) olmak üzere 46 hasta dahil edildi. Erkek hastaların sayısı daha fazla olup erkek/kadın oranı 30/16 idi. Grup 1’deki hastalar Grup 2’ye göre daha genç idi (p<0.05). Grup 1’de hastanede kalış süresi ve postoperative komplikasyon daha yüksek idi (p>0.05). MD uzunluğu Grup 1’de daha uzun, taban çapı ise daha küçük iken gruplar arasında fark saptanmadı (p>0.05). Sonuç: Semptomatik Meckel divertikülitlerinde rezeksiyon sonrasında komplikasyon oranları daha yüksek iken, insidental Meckel divertiküllerinde hastanede kalış süresinin primer cerrahiye bağlı daha uzun olabileceği akılda tutulmalıdır.

References

  • 1.Lequet J, Menahem B, Alves A, Fohlen A, Mulliri A. Meckel's diverticulum in the adult. J Visc Surg. 2017;154:253-9.
  • 2.Kuru S, Kismet K. Meckel's diverticulum: clinical features, diagnosis and management. Rev Esp Enferm Dig. 2018;110:726-32.
  • 3.Hansen CC, Søreide K. Systematic review of epidemiology, presentation, and management of Meckel's diverticulum in the 21st century. Medicine (Baltimore). 2018;97:e12154.
  • 4.Toktaş O, Batur A. Small bowel obstruction caused by giant Meckel’s diverticulum. Turk J Colorectal Dis. 2016;26:56-8.
  • 5.Rossi P, Gourtsoyiannis N, Bezzi M, Raptopoulos V, Massa R, Capanna G et al. Meckel's diverticulum: imaging diagnosis. AJR Am J Roentgenol. 1996;166:567-73.
  • 6.Park JJ, Wolff BG, Tollefson MK, Walsh EE, Larson DR. Meckel diverticulum: the Mayo Clinic experience with 1476 patients (1950-2002). Ann Surg. 2005;241:529-33.
  • 7.Choi SY, Hong SS, Park HJ, Lee HK, Shin HC, Choi GC. The many faces of Meckel's diverticulum and its complications. J Med Imaging Radiat Oncol. 2017;61:225-31.
  • 8.Zani A, Eaton S, Rees CM, Pierro A. Incidentally detected Meckel diverticulum: to resect or not to resect? Ann Surg. 2008;247:276-81.
  • 9.Bani-Hani KE, Shatnawi NJ. Meckel's diverticulum: comparison of incidental and symptomatic cases. World J Surg. 2004;28:917-20.
  • 10.Malcom RJ, Iglesias IM, Smith-Singares E. Perforated giant Meckel diverticulitis in an elderly patient: Case report and review of the literature. Int J Surg Case Rep. 2018;43:45-8.
  • 11.McKay R. High incidence of symptomatic Meckel's diverticulum in patients less than fifty years of age: an indication for resection. Am Surg. 2007;73:271-5. Erratum in: Am Surg. 2007;73:1293.
  • 12.van Malderen K, Vijayvargiya P, Camilleri M, Larson DW, Cima R. Malignancy and Meckel's diverticulum: A systematic literature review and 14-year experience at a tertiary referral center. United European Gastroenterol J. 2018;6:739-47.
  • 13.Kotha VK, Khandelwal A, Saboo SS, Shanbhogue AK, Virmani V, Marginean EC et al. Radiologist's perspective for the Meckel's diverticulum and its complications. Br J Radiol. 2014;87:20130743.
  • 14.Mora-Guzmán I, Muñoz de Nova JL, Martín-Pérez E. Meckel's diverticulum in the adult: surgical treatment. Acta Chir Belg. 2019;119:277-81.
  • 15.Yahchouchy EK, Marano AF, Etienne JC, Fingerhut AL. Meckel's diverticulum. J Am Coll Surg. 2001;192:658-62.
  • 16.Romano F, Franciosi C, Cerea K, Bravo AF, Colombo G, Isimbaldi G et al. A case of carcinoid of Meckel's diverticulum associated with gastric adenocarcinoma. Tumori. 2001;87:272-5.
  • 17.Lindeman RJ, Søreide K. The many faces of Meckel's diverticulum: Update on management in incidental and symptomatic patients. Curr Gastroenterol Rep. 2020;22:3.
  • 18.Groebli Y, Bertin D, Morel P. Meckel's diverticulum in adults: retrospective analysis of 119 cases and historical review. Eur J Surg. 2001;167:518-24.
  • 19.Zingg U, Vorburger S, Metzger U. Perforation of Meckel's diverticulum by a toothpick. Chirurg. 2000;71:841-3.
  • 20.Cullen JJ, Kelly KA, Moir CR, Hodge DO, Zinsmeister AR, Melton LJ 3rd. Surgical management of Meckel's diverticulum. An epidemiologic, population-based study. Ann Surg. 1994;220: 564- 68; discussion 568-9.

Comparison of Postoperative Complications of Diverticulectomy in Symptomatic and Incidental Meckel’s Diverticulum

Year 2022, Volume: 1 Issue: 1, 1 - 6, 25.06.2022

Abstract

Aim: Management of incidental Meckel’s diverticulum (MD) in adults is controversial. This study aims to compare the postoperative complications of diverticulectomy in incidental and symptomatic MD. Materials and Methods: Adult patients with MD who were surgically treated in our clinic between January 2010 and December 2020 were analyzed retrospectively. Patients were divided into two groups according to the presence of symptomatic and incidental diverticula. Age, sex, preoperative laboratory values, histopathological results, lenght of hospital stay, and postoperative complications were compared between the groups. Results: A total of 46 patients, symptomatic (Group 1, 78.2%) and incidental (Group 2, 21.8%), were included in the study. The male/female ratio was 30/16. Patients in Group 1 were younger than those in Group 2 (p<0.05). The hospital duration and postoperative complications in Group 1 were lesser than Group 2 (p>0.05). The MD dimension was longer and the base diameter was shorter in Group 1. No difference was observed between Group 1 and Group 2 in terms of MD dimension and base diameter (p>0.05). Conclusion: Although the incidence of complications after resection is higher in symptomatic MD, it is not significant when compared to the rate of complication development after surgery in incidental MD.

References

  • 1.Lequet J, Menahem B, Alves A, Fohlen A, Mulliri A. Meckel's diverticulum in the adult. J Visc Surg. 2017;154:253-9.
  • 2.Kuru S, Kismet K. Meckel's diverticulum: clinical features, diagnosis and management. Rev Esp Enferm Dig. 2018;110:726-32.
  • 3.Hansen CC, Søreide K. Systematic review of epidemiology, presentation, and management of Meckel's diverticulum in the 21st century. Medicine (Baltimore). 2018;97:e12154.
  • 4.Toktaş O, Batur A. Small bowel obstruction caused by giant Meckel’s diverticulum. Turk J Colorectal Dis. 2016;26:56-8.
  • 5.Rossi P, Gourtsoyiannis N, Bezzi M, Raptopoulos V, Massa R, Capanna G et al. Meckel's diverticulum: imaging diagnosis. AJR Am J Roentgenol. 1996;166:567-73.
  • 6.Park JJ, Wolff BG, Tollefson MK, Walsh EE, Larson DR. Meckel diverticulum: the Mayo Clinic experience with 1476 patients (1950-2002). Ann Surg. 2005;241:529-33.
  • 7.Choi SY, Hong SS, Park HJ, Lee HK, Shin HC, Choi GC. The many faces of Meckel's diverticulum and its complications. J Med Imaging Radiat Oncol. 2017;61:225-31.
  • 8.Zani A, Eaton S, Rees CM, Pierro A. Incidentally detected Meckel diverticulum: to resect or not to resect? Ann Surg. 2008;247:276-81.
  • 9.Bani-Hani KE, Shatnawi NJ. Meckel's diverticulum: comparison of incidental and symptomatic cases. World J Surg. 2004;28:917-20.
  • 10.Malcom RJ, Iglesias IM, Smith-Singares E. Perforated giant Meckel diverticulitis in an elderly patient: Case report and review of the literature. Int J Surg Case Rep. 2018;43:45-8.
  • 11.McKay R. High incidence of symptomatic Meckel's diverticulum in patients less than fifty years of age: an indication for resection. Am Surg. 2007;73:271-5. Erratum in: Am Surg. 2007;73:1293.
  • 12.van Malderen K, Vijayvargiya P, Camilleri M, Larson DW, Cima R. Malignancy and Meckel's diverticulum: A systematic literature review and 14-year experience at a tertiary referral center. United European Gastroenterol J. 2018;6:739-47.
  • 13.Kotha VK, Khandelwal A, Saboo SS, Shanbhogue AK, Virmani V, Marginean EC et al. Radiologist's perspective for the Meckel's diverticulum and its complications. Br J Radiol. 2014;87:20130743.
  • 14.Mora-Guzmán I, Muñoz de Nova JL, Martín-Pérez E. Meckel's diverticulum in the adult: surgical treatment. Acta Chir Belg. 2019;119:277-81.
  • 15.Yahchouchy EK, Marano AF, Etienne JC, Fingerhut AL. Meckel's diverticulum. J Am Coll Surg. 2001;192:658-62.
  • 16.Romano F, Franciosi C, Cerea K, Bravo AF, Colombo G, Isimbaldi G et al. A case of carcinoid of Meckel's diverticulum associated with gastric adenocarcinoma. Tumori. 2001;87:272-5.
  • 17.Lindeman RJ, Søreide K. The many faces of Meckel's diverticulum: Update on management in incidental and symptomatic patients. Curr Gastroenterol Rep. 2020;22:3.
  • 18.Groebli Y, Bertin D, Morel P. Meckel's diverticulum in adults: retrospective analysis of 119 cases and historical review. Eur J Surg. 2001;167:518-24.
  • 19.Zingg U, Vorburger S, Metzger U. Perforation of Meckel's diverticulum by a toothpick. Chirurg. 2000;71:841-3.
  • 20.Cullen JJ, Kelly KA, Moir CR, Hodge DO, Zinsmeister AR, Melton LJ 3rd. Surgical management of Meckel's diverticulum. An epidemiologic, population-based study. Ann Surg. 1994;220: 564- 68; discussion 568-9.
There are 20 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Semra Demirli Atıcı 0000-0002-8287-067X

Ufuk Uylaş 0000-0003-4195-5498

Cem Tuğmen 0000-0002-2668-5197

Erdinç Kamer 0000-0002-5084-5867

Publication Date June 25, 2022
Submission Date April 29, 2022
Published in Issue Year 2022 Volume: 1 Issue: 1

Cite

APA Demirli Atıcı, S., Uylaş, U., Tuğmen, C., Kamer, E. (2022). Semptomatik ve İnsidental Meckel Divertiküllerinde Uygulanan Divertikülektominin Postoperatif Komplikasyonlarının Karşılaştırılması. İzmir Tıp Fakültesi Dergisi, 1(1), 1-6.
AMA Demirli Atıcı S, Uylaş U, Tuğmen C, Kamer E. Semptomatik ve İnsidental Meckel Divertiküllerinde Uygulanan Divertikülektominin Postoperatif Komplikasyonlarının Karşılaştırılması. İzmir Tıp Fak. Derg. June 2022;1(1):1-6.
Chicago Demirli Atıcı, Semra, Ufuk Uylaş, Cem Tuğmen, and Erdinç Kamer. “Semptomatik Ve İnsidental Meckel Divertiküllerinde Uygulanan Divertikülektominin Postoperatif Komplikasyonlarının Karşılaştırılması”. İzmir Tıp Fakültesi Dergisi 1, no. 1 (June 2022): 1-6.
EndNote Demirli Atıcı S, Uylaş U, Tuğmen C, Kamer E (June 1, 2022) Semptomatik ve İnsidental Meckel Divertiküllerinde Uygulanan Divertikülektominin Postoperatif Komplikasyonlarının Karşılaştırılması. İzmir Tıp Fakültesi Dergisi 1 1 1–6.
IEEE S. Demirli Atıcı, U. Uylaş, C. Tuğmen, and E. Kamer, “Semptomatik ve İnsidental Meckel Divertiküllerinde Uygulanan Divertikülektominin Postoperatif Komplikasyonlarının Karşılaştırılması”, İzmir Tıp Fak. Derg., vol. 1, no. 1, pp. 1–6, 2022.
ISNAD Demirli Atıcı, Semra et al. “Semptomatik Ve İnsidental Meckel Divertiküllerinde Uygulanan Divertikülektominin Postoperatif Komplikasyonlarının Karşılaştırılması”. İzmir Tıp Fakültesi Dergisi 1/1 (June 2022), 1-6.
JAMA Demirli Atıcı S, Uylaş U, Tuğmen C, Kamer E. Semptomatik ve İnsidental Meckel Divertiküllerinde Uygulanan Divertikülektominin Postoperatif Komplikasyonlarının Karşılaştırılması. İzmir Tıp Fak. Derg. 2022;1:1–6.
MLA Demirli Atıcı, Semra et al. “Semptomatik Ve İnsidental Meckel Divertiküllerinde Uygulanan Divertikülektominin Postoperatif Komplikasyonlarının Karşılaştırılması”. İzmir Tıp Fakültesi Dergisi, vol. 1, no. 1, 2022, pp. 1-6.
Vancouver Demirli Atıcı S, Uylaş U, Tuğmen C, Kamer E. Semptomatik ve İnsidental Meckel Divertiküllerinde Uygulanan Divertikülektominin Postoperatif Komplikasyonlarının Karşılaştırılması. İzmir Tıp Fak. Derg. 2022;1(1):1-6.