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Laparoscopic approach to Meckel's diverticulum

World Journal of Gastroenterology 2014年第25期20卷 8173-8178页

作者： Alfonso Papparella Fabiano Nino Carmine Noviello Antonio marte Pio Parmeggiani Ascanio Martino giovanni Cobellis Departments of Paediatrics Paediatric Surgery Faculty of Medicine Paediatric Surgery-Second University of Naples80138 NaplesItaly Paediatric Surgery Unit-Salesi Children Hospital 60121 AnconaItaly

AIM: To retrospective review the laparoscopic management of Meckel Diverticulum(MD) in two Italian Pediatric Surgery ***: Between January 2002 and December 2012, 19 trans-umbilical laparoscopic-assisted(TULA) procedures were performed for suspected MD. The children were hospitalized for gastrointestinal bleeding and/or recurrent abdominal pain. Median age at diagnosis was 5.4 years(range 6 mo-15 years). The study included 15 boys and 4 girls. All patients underwent clinical examination, routine laboratory tests, abdominal ultrasound and technetium-99m pertechnetate scan, and patients with bleeding underwent gastrointestinal endoscopy. The abdominal exploration was performed with a 10 mm operative laparoscope. Pneumoperitoneum was establishedbased on the body weight. Systematic overview of the peritoneal cavity allowed the ileum to be grasped with an atraumatic instrument. The complete exploration and surgical treatment of MD were performed extracorporeally, after intestinal exteriorization through the umbilicus. All patients' demographics, main clinical features, diagnostic investigations, operative time, histopathology reports, conversion rate, hospital stay and complications were registered and ***: MD was identified in 17 patients, while 1 had an ileal duplication and 1 a jejunal hemangioma. Fifteen patients had painless intestinal bleeding, while 4 had recurrent abdominal pain and exhibited cyst like structures in an ultrasound study. Eleven patients had a positive technetium-99m pertechnetate scan. In the patients with bleeding, gastrointestinal endoscopy did not name the source of hemorrhage. All patients were subjected to a TULA surgical procedure. An intestinal resection/anastomosis was performed in 14 patients, while 4 had a wedge resection of the diverticulum and 1 underwent stapling diverticulectomy. All surgical procedures were performed without conversion to open laparotomy. Mean operative time was 75 min(range 40-115 min). No m

关键词： Meckel's diverticulum Laparoscopy One trocar surgery Gastrointestinal bleeding Minimal invasive surgery Ileal duplication Jejunal hemangioma

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