Annals of surgery · 2008
Incidentally detected Meckel diverticulum: to resect or not to resect?
СтатьяПоддержка исследования: вне правительства СШАСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zani Augusto, Eaton Simon, Rees Clare M, Pierro Agostino
Аннотация
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.
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.