Recent reports have recommended laparoscopic diverticulectomy for symptomatic Meckel diverticulum (MD) rather than laparoscopic-assisted extracorporeal resection. This technique may risk leaving residual ectopic mucosa leading to complications. This systematic review attempts to quantify the relative risks of both approaches. A systematic review was conducted according to PRISMA guidelines. Articles were eligible for inclusion if they reported data on the laparoscopic management of symptomatic MD in children. Eleven reports were identified, all of which were institutional retrospective studies. Pooled outcome data on 248 children showed no statistically significant difference in complications between laparoscopic diverticulectomy ( n = 133) and laparoscopic-assisted segmental resection ( n = 115) (3% vs. 6.1%, p = 0.39). One patient from the diverticulectomy group re-presented with recurrent bleeding necessitating segmental small bowel resection. Conclusions are limited by the number of patients and variable follow up. Short, wide MD with a height:base ratio of < 2; diverticula with thickening or ischemia at the base and those complicated by volvulus or small bowel obstruction are probably best treated by laparoscopic-assisted extracorporeal resection. For other symptomatic diverticula laparoscopic diverticulectomy is a reasonable approach with a less than 1% risk of leaving residual ectopic gastric mucosa.

中文翻译：

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腹腔镜憩室切除术或腹腔镜辅助切除儿童症状性梅克尔憩室？系统评价

最近的报告推荐腹腔镜憩室切除术治疗有症状的梅克尔憩室 (MD)，而不是腹腔镜辅助的体外切除术。这种技术可能会留下残留的异位黏膜，导致并发症。本系统评价试图量化两种方法的相对风险。根据 PRISMA 指南进行了系统评价。如果文章报告了儿童症状性 MD 的腹腔镜治疗数据，则有资格纳入。确定了 11 份报告，所有这些报告都是机构回顾性研究。248 名儿童的汇总结果数据显示，腹腔镜憩室切除术 (n = 133) 和腹腔镜辅助节段性切除术 (n = 115) 的并发症无统计学差异（3% 对 6.1%，p = 0.39）。憩室切除术组的一名患者再次出现需要节段性小肠切除术的复发性出血。结论受到患者数量和可变随访的限制。短而宽的 MD，高度与基部之比 < 2；基底增厚或缺血的憩室以及并发肠扭转或小肠梗阻的憩室可能最好通过腹腔镜辅助体外切除术治疗。对于其他有症状的憩室，腹腔镜憩室切除术是一种合理的方法，残留异位胃黏膜的风险低于 1%。基底增厚或缺血的憩室以及并发肠扭转或小肠梗阻的憩室可能最好通过腹腔镜辅助体外切除术治疗。对于其他有症状的憩室，腹腔镜憩室切除术是一种合理的方法，残留异位胃黏膜的风险低于 1%。基底增厚或缺血的憩室以及并发肠扭转或小肠梗阻的憩室可能最好通过腹腔镜辅助体外切除术治疗。对于其他有症状的憩室，腹腔镜憩室切除术是一种合理的方法，残留异位胃黏膜的风险低于 1%。