PDF(Pubmed)
Abstract：
UNASSIGNED: Meckel Diverticulum [MD), a common congenital anomaly of the gastrointestinal tract, poses a dilemma when incidentally encountered during surgery. Despite historical descriptions and known complications of symptomatic MD, the decision to resect an incidental MD (IMD) lacks clear guidelines. This study aims to assess whether resecting IMDs is justified by synthesizing evidence from studies published between 2000 and 2023. Factors influencing this decision, such as demographic risks, surgical advancements and complications, are systematically examined.
UNASSIGNED: Following the PRISMA 2020 guidelines, this review incorporates 42 eligible studies with data on outcomes of asymptomatic MD management. Studies, both favoring and opposing resection, were analyzed.
UNASSIGNED: Considering complications, malignancy potential, and operative safety, the risk-benefit analysis presents a nuanced picture. Some authors propose conditional resection based on specific criteria, emphasizing patient-specific factors. Of 2934 cases analyzed for short- and long-term complications, the morbidity rate was 5.69%. Of 571 cases where mortality data were available, all 5 fatalities were attributed to the primary disease rather than IMD resection.
UNASSIGNED: The sporadic, unpredictable presentation of IMD and the variability of both the primary disease and the patient make formulation of definitive guidelines challenging. The non-uniformity of complications reporting underscores the need for standardized categorization. While the balance of evidence leans towards resection of IMDs, this study acknowledges the individualized nature of this decision. Increased safety in surgery and anesthesia, along with better understanding and management of complications favor a judicious preference for resection, while taking into account patient characteristics and the primary disease.
UNASSIGNED: Following the PRISMA 2020 guidelines, this review incorporates 42 eligible studies with data on outcomes of asymptomatic MD management. Studies, both favoring and opposing resection, were analyzed.
UNASSIGNED: Considering complications, malignancy potential, and operative safety, the risk-benefit analysis presents a nuanced picture. Some authors propose conditional resection based on specific criteria, emphasizing patient-specific factors. Of 2934 cases analyzed for short- and long-term complications, the morbidity rate was 5.69%. Of 571 cases where mortality data were available, all 5 fatalities were attributed to the primary disease rather than IMD resection.
UNASSIGNED: The sporadic, unpredictable presentation of IMD and the variability of both the primary disease and the patient make formulation of definitive guidelines challenging. The non-uniformity of complications reporting underscores the need for standardized categorization. While the balance of evidence leans towards resection of IMDs, this study acknowledges the individualized nature of this decision. Increased safety in surgery and anesthesia, along with better understanding and management of complications favor a judicious preference for resection, while taking into account patient characteristics and the primary disease.
摘要：
■Meckel憩室[MD)，常见的先天性胃肠道异常，在手术过程中偶然遇到的情况会带来两难选择。尽管有历史描述和已知有症状的MD的并发症，切除附带MD(IMD)的决定缺乏明确的指导方针.这项研究旨在通过综合2000年至2023年之间发表的研究证据来评估切除IMD是否合理。影响这一决定的因素，比如人口风险，手术进展和并发症，进行了系统的检查。
■遵循PRISMA2020指南，本综述纳入了42项符合条件的研究,其中包含有关无症状MD治疗结局的数据.研究,既赞成又反对切除，进行了分析。
■考虑到并发症，恶性潜能，和操作安全，风险-收益分析呈现了一幅细微差别的图景。一些作者提出了基于特定标准的条件切除，强调患者的特定因素。在2934例短期和长期并发症分析中，发病率为5.69％。在有死亡率数据的571例病例中，所有5例死亡均归因于原发疾病,而非IMD切除.
■零星的，IMD的不可预测的表现以及原发疾病和患者的变异性使得制定明确的指南具有挑战性。并发症报告的不均匀性强调了标准化分类的必要性。虽然证据的平衡倾向于切除IMD，这项研究承认这一决定的个性化。增加手术和麻醉的安全性，随着对并发症的更好理解和管理，有利于对切除的明智选择，同时考虑到患者特征和原发疾病。
■遵循PRISMA2020指南，本综述纳入了42项符合条件的研究,其中包含有关无症状MD治疗结局的数据.研究,既赞成又反对切除，进行了分析。
■考虑到并发症，恶性潜能，和操作安全，风险-收益分析呈现了一幅细微差别的图景。一些作者提出了基于特定标准的条件切除，强调患者的特定因素。在2934例短期和长期并发症分析中，发病率为5.69％。在有死亡率数据的571例病例中，所有5例死亡均归因于原发疾病,而非IMD切除.
■零星的，IMD的不可预测的表现以及原发疾病和患者的变异性使得制定明确的指南具有挑战性。并发症报告的不均匀性强调了标准化分类的必要性。虽然证据的平衡倾向于切除IMD，这项研究承认这一决定的个性化。增加手术和麻醉的安全性，随着对并发症的更好理解和管理，有利于对切除的明智选择，同时考虑到患者特征和原发疾病。
