Incidental Meckel's diverticulectomy in adults.
BACKGROUND
Incidental Meckel's diverticulectomy has been advocated by some surgeons because of the lower associated morbidity and mortality in this setting than when resection is indicated. Others have argued that the low risk of complication occurrence does not justify prophylactic removal. The issue remains controversial.


METHODS
Medical records of all adults undergoing Meckel's diverticulectomy at four acute care hospitals during the 5-year period 1989 through 1993 were retrospectively reviewed. Decision analysis was used to determine relative risks for incidental resection compared to indicated resection for a complication.


RESULTS
Ninety patients underwent incidental diverticulectomy. Morbidity was 2% and mortality 0%. Four patients underwent resection for a complication of their diverticulum. Morbidity and mortality were each 0%. Combining these results with previously reported results and using decision analysis, the conditional probabilities of producing surgical morbidity or mortality in the adult population at risk by only resecting symptomatic diverticula are 0.2% and 0.04%, respectively. The comparable risks for resecting all incidentally discovered diverticula are 4.6% and 0.2%.


CONCLUSIONS
Incidental diverticulectomy in adults should be abandoned.
Peoples
J B
JB
Department of Surgery, Wright State University School of Medicine, Dayton, Ohio, USA.
Lichtenberger
E J
EJ
Dunn
M M
MM
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008467:Meckel Diverticulum / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome