Meckel’s Diverticulum: A National Surgical Quality Improvement Program Survey in Adults Comparing Diverticulectomy and Small Bowel Resection

• Published in: The American surgeon 2021-06, Vol.87 (6), p.892-896
• Main Authors: Brungardt, Joseph G., Cummiskey, Brian R., Schropp, Kurt P.
• Format: Article
• Language: English
• Subjects: Adults; Appendectomy; Criteria; Demographics; Demography; Diverticulum; Females; Hospitals; Infections; Length of stay; Males; Mortality; Patients; Pediatrics; Populations; Postoperative period; Quality control; Quality improvement; Small intestine; Thrombosis; Wound infection
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/0003134820954820

Background Meckel’s diverticulum is a congenital abnormality often associated with the pediatric population. When seen in the adult population, management is controversial. This study sought to determine demographic and outcome differences between diverticulectomy and small bowel resection in adults diagnosed with Meckel’s diverticulum. Methods An analysis of the American College of Surgeons National Surgical Quality Improvement database (2015-2018) was performed, capturing patients with a postoperative diagnosis of Meckel’s diverticulum. Inclusion criteria included diverticulectomy or small bowel resection, and exclusion criteria included other major procedures such as colectomy or concomitant diverticulectomy and a small bowel resection. Demographics and outcomes were analyzed between those receiving diverticulectomy or resection. Results 506 patients undergoing surgical treatment of Meckel’s diverticulum were captured. The majority of these patients were white (79.05%), male (68.77%), and averaged 46 years old. The 2 populations were homogenous, with no significant differences in demographics or comorbidities between populations. Mean operative time was shorter in the diverticulectomy group than the resection group (68.92 ± 35.89 vs. 89.33 ± 40.16 minutes, P < .0001). There were no deaths at 30 days. Length of stay, readmission rate, wound infection, and discharge destination were similar among both groups. Discussion Our analysis of a national database reveals no difference in outcomes between patients receiving a diverticulectomy or resection for Meckel’s diverticulum. Operating time may be slightly increased for resection. However, decision to excise the diverticulum vs. the segment of small bowel should be individualized to each patient, their pathology, and clinical picture.