A retrospective study on the treatment of children with meckel diverticulum and intestinal duplication malformation by two different surgical protocols

doi:10.3877/cma.j.issn.1674-3946.2025.04.009.

Abstract

Abstract:

Objective

To compare the efficacy and safety of two different surgical protocols in the treatment of children with Meckel diverticulum complicated by intestinal duplication malformation.

Methods

The clinical data of 102 children with Meckel diverticulum complicated by intestinal duplication malformation from January 2019 to October 2024 were retrospectively analyzed. According to different surgical methods, the children were divided into group A (n=44 cases, receiving conventional open surgery) and group B (n=58 cases,receiving laparoscopic surgery). The data were analyzed using SPSS 25.0 software. The intraoperative related indexes, postoperative recovery status and inflammatory indexes of the children were all expressed as (), and independent sample t tests were used; χ² tests were used for categorical variables such as clinical efficacy and postoperative complications. P<0.05 indicated a statistically significant difference.

Results

The operation time of children in group B was longer than that in group A (P<0.05), the intraoperative blood loss in group B was significantly less than that in group A (P<0.05), and the incision length in group B was significantly smaller than that in group A (P<0.05); The postoperative recovery status of children in group B was better than that in group A, and the time of first exhaust and the time of first feeding were both earlier than those in group A (P<0.05);The abdominal pain degree (VAS) score of children in group B was significantly lower than that in group A(P<0.05); Three days after the operation, the intestinal function recovery rate of children in group B was faster,and the concentrations of lactate dehydrogenase (LDH) and serum D-lactic acid were significantly lower than those in group A (P<0.05); Three days after the operation, the inflammatory response of children in group B was better than that in group A, that is, the levels of C-reactive protein (CRP) and white blood cell count (WBC)in children of group B were lower than those in group A (P<0.05); The clinical efficacy of children in group B was significantly improved compared with that in group A (93.1% vs. 79.5%, P<0.05); The incidences of complications such as intra-abdominal infection, intestinal fistula, intestinal obstruction and incision bleeding in children of group B after the operation were significantly lower than those in group A (13.7% vs. 40.9%,P<0.05).

Conclusion

Laparoscopic surgery shows significant minimally invasive advantages in the treatment of Meckel diverticulum complicated by intestinal duplication malformation, with rapid postoperative recovery and fewer complications.

Key words: Meckel Diverticulum, Intestinal Duplication, Laparoscopes, Laparotomy, Postoperative Complications, Comparative Effectiveness Research

Guolong Ning, Wei Zuo. A retrospective study on the treatment of children with meckel diverticulum and intestinal duplication malformation by two different surgical protocols[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(04): 380-383.

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Figures/Tables 4

组别	例数	性别（例）	年龄（岁， $\overset{ˉ}{x}$ ± s ）	BMI(kg/m²， $\overset{ˉ}{x}$ ± s )
组别	例数	男/女	年龄（岁， $\overset{ˉ}{x}$ ± s ）	BMI(kg/m²， $\overset{ˉ}{x}$ ± s )
A组	44	27/17	5. 7±1. 5	15. 6±2. 3
B组	58	35/23	5. 9±1. 6	15. 4±2. 2
χ ²/t 值		0. 011	-0. 565	0. 489
P值		0. 917	0. 573	0. 626
组别	例数	Meckel憩室长度(cm， $\overset{ˉ}{x}$ ± s )	Mecekl憩室病理构成分布（例）	肠重复畸形部位（例）
组别	例数	Meckel憩室长度(cm， $\overset{ˉ}{x}$ ± s )	A/B	C/D/E
A组	44	3. 2±1. 4	32/12	31/10/3
B组	58	3. 2±1. 5	35/23	39/15/4
χ ²/t 值		-0. 235	1. 702	0. 138
P值		0. 815	0. 192	0. 933

组别	例数	性别（例）	年龄（岁， $\overset{ˉ}{x}$ ± s ）	BMI(kg/m²， $\overset{ˉ}{x}$ ± s )
组别	例数	男/女	年龄（岁， $\overset{ˉ}{x}$ ± s ）	BMI(kg/m²， $\overset{ˉ}{x}$ ± s )
A组	44	27/17	5. 7±1. 5	15. 6±2. 3
B组	58	35/23	5. 9±1. 6	15. 4±2. 2
χ ²/t 值		0. 011	-0. 565	0. 489
P值		0. 917	0. 573	0. 626
组别	例数	Meckel憩室长度(cm， $\overset{ˉ}{x}$ ± s )	Mecekl憩室病理构成分布（例）	肠重复畸形部位（例）
组别	例数	Meckel憩室长度(cm， $\overset{ˉ}{x}$ ± s )	A/B	C/D/E
A组	44	3. 2±1. 4	32/12	31/10/3
B组	58	3. 2±1. 5	35/23	39/15/4
χ ²/t 值		-0. 235	1. 702	0. 138
P值		0. 815	0. 192	0. 933

组别	例数	手术时间（min）	术中出血量（ml）	切口长度（cm）
A组	44	85. 3±8. 7	110.6±15.4	7. 8±1. 4
B组	58	105. 4±10. 8	88.3±10.6	5. 4±1. 2
t 值		9. 759	8.654	8. 898
P值		＜0. 001	＜0. 001	＜0. 001
组别	例数	首次排次时间（h）	首次进食时间（h）	VAS评分（分）
A组	44	65. 4±15. 8	42. 7±10. 4	6. 2±1. 4
B组	58	48. 3±10. 6	28. 1±8. 3	4. 4±1. 2
t 值		6. 218	7. 604	6. 981
P值		＜0. 001	＜0. 001	＜0. 001

组别	例数	时间	血清LDH(U/L)	D- 乳酸(mmol/L)	CRP(mg/L)	WBC(×10⁹/L)
A组	44	术前	190. 3±45. 6	3. 3±1. 6	15. 2±4. 1	11. 3±2. 6
		术后3d	153. 8±32. 7^a	2. 6±0. 6^a	13. 8±3. 7^a	9. 8±1. 2^a
B组	58	术前	188. 2±44. 5	3. 2±1. 5	15. 1±4. 2	11. 2±2. 4
		术后3d	125. 5±25. 6^ab	1. 8±0. 4^ab	10. 5±2. 4^ab	7. 6±1. 1^ab

组别	例数	显效	有效	无效	总有效
A组	44	15(34. 1)	20(45. 4)	9(20. 5)	35(79. 5)
B组	58	36(62. 1)	18(31. 0)	4(6. 9)	54(93. 1)
χ ²值		-	-	-	4. 136
P值		-	-	-	0. 042

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