Carcinoid tumours of the appendix: an analysis of emergency appendicectomies over a 24‐year period and outcomes of laparoscopic versus open resection (original) (raw)

Appendix tumors in the era of laparoscopic appendectomy

Surgical Endoscopy And Other Interventional Techniques, 2004

Background: The safety of laparoscopic appendectomy for the management of incidentally discovered appendiceal tumors has not yet been established. Methods: Appendiceal tumor cases managed by laparoscopy or laparotomy over a 10-year period were reviewed. Results: The pathological diagnoses were 23 carcinoid and 20 cancerous lesions. The median patient ages were 36 and 69 years, respectively, for carcinoid and other tumors (p < 0.05). Acute appendicitis was present in 70% of carcinoid cases and 35% of other tumors (p < 0.05). Eight patients with carcinoid tumors were operated on by laparoscopy, whereas 15 underwent laparotomy. Laparoscopic and open procedures were performed in three and 17 patients with cancerous lesions, respectively. Invaded surgical margins were seen after laparoscopy in 20% of patients and open surgery in 6%. Synchronous colon carcinoma was detected in 14% of the patients with an appendix neoplasm. The 5-year survival rates were similar after both laparoscopic and open appendectomy for either carcinoid or other tumors. Conclusion: Laparoscopic appendectomy for appendiceal tumors seems to have a slightly higher rate of inadequate resection. However, it is not associated with a significantly worse patient prognosis than open appendectomy.

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...

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: 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 (

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.

Comparison of carcinoid tumors with the other tumors of appendix

Annals of Medical Research, 2019

Carcinoid tumor is the most frequent primary tumor of the appendix which may reach up to 60% of all appendiceal neoplasms. We aimed to evaluate the incidental appendiceal carcinoid tumors following acute appendicitis analyzing the demographics, clinical, laboratory, pathological features and follow-up results of the patients. Material and Methods: We evaluated the patients retrospectively who had been operated for acute appendicitis between January 2006 and May 2018. Results: We found 29 patients with carcinoid tumor among 7122 cases (0.4%) between 2006-2018. Median size of tumors was found to be 7.5 mm (Min: 0.8, max: 20 mm). While appendectomy was sufficient for 27 of the patients, right hemicolectomy was performed for 2 cases. When labaratory values were analysed the neutrophil / WBC ratio was significantly higher and lymphocyte count in the study group was significantly lower than control group (p < 0.05). The neutrophil / lymphocyte ratio was significantly higher than control group (p < 0.05). Conclusion: Evaluation of laboratory values at admission, histopathological examination of appendiceal specimens, early diagnosis of cancer and performing the appropriate treatment are required for the survival of patients.

Carcinoid Tumors : An Ignored Cause of Appendicitis

2014

Background: Many conditions related to appendix present as appendicitis. These conditions can range from fecolith obstruction to tumors .Carcinoid tumors are most common tumors to present in appendix. Most of the carcinoid tumors in appendix present as appendicitis. Majority of the cases are diagnosed after histopathological examination, with 90% of the tumors measuring smaller than 1 cm with excellent prognosis after appendectomies. Tumors with the size of 2cm are treated with right hemicolectomy. Objective: To determine the frequency of carcinoid tumors in appendectomies using histopathological

Carcinoid Tumors of Appendix Presenting as Acute Appendicitis

Turkish Journal of Trauma and Emergency Surgery, 2018

BACKGROUND: We aim to present the data of patients who underwent appendectomy due to acute appendicitis, and incidental carcinoid tumor was detected on pathology. METHODS: Retrospective analysis of the patient charts between January 1999 and September 2018 were performed. RESULTS: 2778 appendectomy was performed due to acute appendicitis. Appendiceal carcinoid tumor was detected in 12 (0.43%) patients. Eight patients were (66.7%) female. Median age 37.5 years (range: 21-60). The median tumor size was 0.7 cm (range: 0.1-2.5). No perforation was detected. Eleven patients underwent appendectomy, and one patient had right hemicolectomy. The median followup period was 41.5 months (range: 22-49). There were no recurrences. CONCLUSION: Appendix carcinoid tumors are quite rare, usually asymptomatic and diagnosed incidentally on histopathological examination after appendectomy. The treatment of carcinoid tumors of the appendix is directly related to the tumor size, localization, presence of lymphovascular and mesoappendix invasion, mitotic activation rate and level of Ki67. Thus, it is important to follow the histopathological results after appendectomy. The prognosis of appendix carcinoid tumors is very good if the appendix is non-perforated.

[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...

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...