Appendix tumors in the era of laparoscopic appendectomy (original) (raw)
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Laparoscopic versus open resection for appendix carcinoid
Surgical Endoscopy, 2006
Background: Since an increasing number of appendectomies are performed via laparoscopy, it is crucial to determine the impact of this approach on appendix carcinoid (AC) outcome. The goal of this study was to compare results of laparoscopic (LAP) versus open (OP) appendectomy for AC according to intend to treat approach. Methods: A retrospective review (1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003) identified 39 patients (median age, 36 years; range, 12-83) treated by laparoscopy (LAP) or laparotomy (OP) for AC in a single institution. Follow-up was complete for all patients (median, 67 months; range, 4-132). Results: Most cases had associated acute appendicitis (64%). Median carcinoid size was 1.1 cm (range, 0.3-5) and 0.4 cm (range, 0.2-3) in the LAP and OP groups, respectively. LAP and OP were performed in 21 (54%) and 18 (46%) patients, respectively. Surgical margins were positive in two patients in the LAP group and one patient in the OP group (p = 0.6). Right colectomies were performed for AC >2 cm in five patients after LAP and in four patients after OP (p = 0.9). Actuarial 5-year survival rates were 100 and 94% in the LAP and OP groups, respectively (p = 0.2). Two patients died in the OP group, one due to metastatic carcinoid and the other due to metachronous colorectal cancer. Synchronous or metachronous colorectal carcinomas developed in six patients (15%). Conclusion: Laparoscopic appendectomy is a safe procedure for AC, with carcinologic and long-term results similar to those of conventional appendectomy. Thus, pre-or per-operative suspicion of AC is not a contraindication to LAP. Prognosis of AC appears more dependent on carcinoid malignant potential or associated tumors. Risk for developing colorectal adenocarcinoma is high in AC patients and warrants follow-up of all patients with colonoscopic screening.
Carcinoid tumor of appendix; retrospective review of 1800 appendectomy patients
Electronic Journal of General Medicine
Malignant tumors of the appendix are rare and the histopathological diagnosis can often be made in the postoperative period. The clinical records of 1800 patients who underwent surgery in emergency conditions with a preliminary diagnosis of acute appendicitis were reviewed retrospectively. Carcinoid tumor was detected in 7 patients (0.38%) on histopathological examination. Of these patients, 4 were male (57.1%), 3 were female (42.9) and the mean age was found to be 36 (22-49). Appendiceal carcinoid tumors are tumors with a good prognosis. Even though their prognosis is good, close monitoring of the patients is recommended due to the likelihood of the detection of a proportion (13-33%) of synchronous and/or metachronous colorectal cancer in the literature.
Carcinoid tumor of the appendix: a consecutive series from 1237 appendectomies
World journal of gastroenterology : WJG, 2006
To report the experience of the CHU Sart Tilman, University of Liege, Belgium, in the management of appendiceal carinoid tumor. A retrospective review of 1237 appendectomies performed in one single centre from January 2000 to May 2004, was undertaken. Analysis of demographic data, clinical presentation, histopathology, operative reports and outcome was presented. Among the 1237 appendectomies, 5 appendiceal carcinoid tumors were identified (0.4%) in 4 male and 1 female patients, with a mean age of 29.2 years (range: 6-82 years). Acute appendicitis was the clinical presentation for all patients. Four patients underwent open appendectomy and one a laparoscopic procedure. One patient was reoperated to complete the excision of mesoappendix. All tumors were located at the tip of the appendix with a mean diameter of 0.6 cm (range: 0.3-1.0 cm). No adjuvant therapy was performed. All patients were alive and disease-free during a mean follow-up of 33 mo. Appendiceal carcinoid tumor most ofte...
Journal of Clinical & Experimental Pathology, 2015
Appendectomy due to acute appendicitis is one of the most common emergency operations that is applied at the general surgery clinics and for this reason neoplasms of appendix may commonly be unforseen. Because unforseen neoplasms of the appendix may cause health problems for the patient and medicolegal problems for the surgeon, we decided to evaluate the histopathological results of the appendectomy specimens that were excised at our clinic between 2012 and 2015. 1332 patients were evaluated and 20 of them were found to have appendicial neoplasms of low-grade mucinous neoplasm in 9 (45%), appendiceal adenoma in 6 (30%), neuroendocrine tumor in 4 (20%) and metastases of gastric adenocarcinoma in 1 (5%) patient. Mean age of patients was 44.6 ± 14.41 years. 13 (65%) were male and 7 (35%) were female. The mean preoperative white blood cell count was 9645.0 ± 4490.3/ mmᶟ. 9 (45%) patient's appendix were able to be evaluated by preoperative abdominal ultrasound and the mean diameter of appendix was 10.65 ± 4.16 mm. None of the patients had meckel diverticulum. Appendectomy was performed to 19 (95%) patients and partial resection of caecum with appendectomy was performed to 1 (5%) patient. The malignant tumors of appendix are adenocarcinomas, carcinoid tumors and extremely rare stromal tumors which they all may mimic acute appendicitis. Adenocarcinomas are belived to be more common than carcinoid tumors as it was not in past. Unforseen neoplasms of appendix may come up with peritoneal carcinomatosis with short survival and cause medicolegal problems for the surgeons. For this reason, surgeons must keep in mind that all appendix caused acute abdomen patients may not be acute appendicitis.
Carcinoid tumor of cecal appendix: one-year incidence at the Santa Marcelina Hospital
Journal of Coloproctology, 2014
Acute appendicitis Carcinoid tumor of the appendix Conduct Follow-up a b s t r a c t Introduction: Carcinoid tumors are neuroendocrine malignancies that originate in the neuroectodermal cells of the Amine, Peptide Uptake and Decarboxylation system dispersed in the gastrointestinal mucosa and representing about 80-88% of tumors of cecal appendix.
Carcinoid tumor of the appendix: report on ten cases
European Journal of Trauma and Emergency Surgery
Aim To conduct a retrospective analysis of the incidence and long-term outcomes of carcinoid tumor of the appendix in emergency appendectomies. Methods From a histopathologic database of 2197 appendectomies from a single center, all appendiceal carcinoid tumors were identified and case notes reviewed. Demographic data, clinical presentation, histopathology, operative reports, and survival were scored and compared with those reported in the literature. Results Ten patients (0.45%) with appendiceal carcinoid tumor were identified (2 male, 8 female; mean age, 29.2 years; age range, 14–56 years). In all cases, the clinical presentation resembled the symptoms of acute appendicitis. Open appendectomy was performed in all patients. All tumors were located at the tip of the appendix, with a mean diameter of 0.4 cm (range, 0.1–0.9 cm), and the mesoappendix was invaded in one patient. No patient had repeat surgery after the initial operation. After a mean follow-up period of 55 months (range, 26–82 months), all patients were alive and disease- and symptom-free. Conclusion To conclude, carcinoid tumors are extremely rare, and the diagnosis is often made after surgery. We emphasise the value of obtaining histopathological analysis of every removed appendix because visual examination does not always correlate with later pathological examination. Furthermore, small appendiceal carcinoids (
[Appendiceal carcinoid tumors. Evaluation of long-term outcomes in a tertiary level]
Cirugía y cirujanos
Appendiceal tumors are found in about 1% of appendectomies performed and 0.5% of intestinal neoplasias. Appendiceal carcinoids are the predominant histology in this group and are usually casual after appendectomy for other reasons. The prognosis is excellent and survival is 95% at 5 years after surgery. Retrospective analysis of all patients with appendiceal carcinoid surgery in our hospital for 20 years (1990-2010) and survival at 5 years. We also discuss the need for additional treatment and testing for follow-up visits. 42 patients underwent surgery for appendiceal carcinoid tumor. 38 of them were operated on urgently, mostly for suspected acute appendicitis, without having reached the carcinoid tumor diagnosed preoperatively in any of them. The predominant symptomatology at admission was abdominal pain. Surgical treatment was appendectomy in 34 patients (12 laparoscopic), 7 patients required colon resections over intraoperatively by colonic involvement; only one patient required...
International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group, 2017
Radiological imaging often underestimates the extent of low volume peritoneal disease. The benefit of laparoscopy in assessing peritoneal metastases from colorectal and gastric cancer is accepted, but is inconclusive for appendiceal malignancy. We report our experience of diagnostic (DL) and therapeutic laparoscopy (TL) in patients with appendiceal tumours to determine indications and role in assessment and management. A retrospective review of a National Peritoneal Malignancy Centre's prospectively maintained database was performed. All patients with appendiceal neoplasms who underwent DL or TL between September 2011 and January 2016 were included. The indications and outcomes of the laparoscopy, complications and interval to laparotomy were evaluated. Six hundred and eighty-five patients underwent surgery for appendiceal neoplasms during the study period, of which 73 (10.6%) underwent laparoscopy (50 DL, 23 TL). The main indications for DL were to clarify imaging and stage pat...
Carcinoid tumour of the appendix: problems of diagnosis and treatment
Chirurgia (Bucharest, Romania : 1990)
Carcinoids (neuroendocrine tumours) are considered the most common primary appendiceal neoplasm. Primary appendiceal tumours are uncommon. Routine histopathological examination of appendicectomy specimens is justified given the not infrequent incidental finding of appendiceal tumours. In cases of appendicitis in the elderly, the index of suspicion for epithelial tumours of the appendix should be raised. Moreover, once the diagnosis of an adenomatous lesion is made, colonoscopic examination of the entire large bowel is mandatory given the frequency of synchronous colorectal neoplasia in our population. In our study, we review 3 cases of carcinoid tumor of the appendix and describe their presentation, treatment and outcome. They are often diagnosed incidentally after histopathological examination of the vermiform appendix submitted in the course of the management of another clinical diagnosis. Appendectomy is appropriate for lesions < 1 cm but for lesions over 2 cm in diameter ther...