Can Decipheri̇ng the Growth of Meckel’s Diverticulum Help Us to Decide Resection Technique?

Purpose The employment of laparoscopic surgical techniques has reignited the debate on managing Meckel's Diverticulum (MD) due to its low complication rates. Nevertheless, concerns have been raised regarding completely removing any potential heterotopic mucosa. Our study aimed to compare surgical approaches in MD and assess the effectiveness of simple diverticulectomy. Methods The morphometric measurements and the location of the heterotopic mucosa were retrospectively analyzed between 2003 and 2022 for 139 patients with MD regarding growth and symptoms. Results Simple diverticulectomy achieved the lowest complication rate (p = 0.03). Length, diameter, and distance to the ileocecal valve increase linearly in the first three years of life (p = 0.00, p = 0.01, p = 0.00) but not in subsequent years As the length increases, the heterotopic mucosa (HM) is displaced distally (p = 0.01). Patients with HM extending to the ileodiverticular border always present with bleeding (p = 0.02). Discussion Simple diverticulectomy is a safe technique for MD’s resection. MD continues to grow until the age of 3 years and the HM is displaced distally and moves away from the ileodiverticular junction. Bleeding is the main symptom in patients with HM reaching the ileodiverticular junction. In patients with bleeding or younger than three years of age, simple diverticulectomy may not be considered safe.