Appendix orifice polyps: a study of 691 lesions at a single institution

Hassab, Tarek; Church, James M.

doi:10.1007/s00384-019-03251-z

Cited by 7 publications

(11 citation statements)

References 12 publications

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“…This study concluded that endoscopic resection of cecal polyps involving the appendiceal orifice is safe and effective in select patients [26]. In terms of the method of resection, a retrospective study was done by Hassab and Church [17] that examined 691 cases of appendiceal orifice polyps removed between 2000 and 2017. They noted that the most common method of excision was cold biopsy forceps (36.3%), followed by a hot snare (9.3%), cold snare (8.5%), jumbo cold forceps (6.7%), hot biopsy (6.8%), and endoscopic mucosal resection/dissection (4%).…”

Section: Discussionmentioning

confidence: 99%

“…0.4% of adenomas contained high-grade dysplasia. They noted 0.1% leiomyomas and 0.8% cancers including 0.4% adenocarcinoma and 0.4% carcinoid tumors [17]. Furthermore, when appendiceal polyps occur, they are more likely to be in the proximal third as opposed to the distal appendix.…”

Section: Discussionmentioning

confidence: 99%

“…Recurrence was seen in 10.3% of patients. Furthermore, the incidence of recurrence, as well as the need for surgical intervention, were more common with polyps measuring more than 5 mm in size [17]. In a small exploratory study, Bronzwaer et al [27] suggest that endoscopic full thickening resection of non-pedunculated polyps between 10 and 15 mm is feasible and is a minimally invasive approach when compared to radical resection.…”

Section: Discussionmentioning

confidence: 99%

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“Obscure” Appendiceal Orifice Polyps Can Be Challenging to Identify by Colonoscopy

Amini

Koury

Vaezi

et al. 2020

Case Rep Gastroenterol

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The primary purpose of screening colonoscopy is the detection and subsequent removal of precancerous polyps. However, effective recognition of appendiceal lesions with a standard endoscope is often challenging and is limited to the base of the cecum and appendiceal orifice. The majority of appendiceal polyps are found incidentally following an appendectomy, though rarely they may be discovered during a colonoscopy. Despite being visualized by colonoscopy, most of these polyps are generally referred for surgical resection. The risk of developing carcinoma in patients with appendiceal polyps is likely similar to that of other colonic polyps, so it is essential for the endoscopist to examine and visualize the appendiceal orifice thoroughly. Various techniques are available to the endoscopist that can increase the accuracy of colonoscopic evaluation. These include luminal inflation and deflation, looking behind and pressing haustral folds, and repetitive passage of the scope over poorly visualized areas. To our knowl- Case Rep Gastroenterol 2020;14:15-26

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

“Obscure” Appendiceal Orifice Polyps Can Be Challenging to Identify by Colonoscopy

Amini

Koury

Vaezi

et al. 2020

Case Rep Gastroenterol

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show abstract

“…[2][3][4] Not all premalignant colorectal lesions are amenable to endoscopic removal and some characteristics, such as size, morphology, or location of the polyp can make endoscopic ablation hazardous despite the development of new techniques. 5,6 This is particularly true for difficult anatomical situations such as the appendix orifice or for large flat cecal lesions. 6,7 In these situations, the patient is referred to surgeon for colorectal resection, and a standard "oncologic" or radical segmental resection is often the only treatment offered.…”

Section: Introductionmentioning

confidence: 99%

“…5,6 This is particularly true for difficult anatomical situations such as the appendix orifice or for large flat cecal lesions. 6,7 In these situations, the patient is referred to surgeon for colorectal resection, and a standard "oncologic" or radical segmental resection is often the only treatment offered. [8][9][10][11] For those polyps located adjacent to the appendix orifice or at the bottom of the cecum, a limited full-thickness wall resection has been previously described.…”

Section: Introductionmentioning

confidence: 99%

Ileocecal Valve Sparing Resection for the Treatment of Benign Cecal Polyps Unsuitable for Polypectomy

Abdalla

Meillat

Fillol

et al. 2021

JSLS

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Background: Not all benign-appearance polyps are amenable to endoscopic removal and colectomy is required in some cases. This study aims to compare the early outcomes of cecal wedge resection with ileocecal valve sparring versus standard right colectomy in patients with endoscopically unresectable cecal polyps referred for surgery.Methods: From Apr 2010 to Aug 2019, all consecutive patients who underwent cecal wedge resection or right colectomy in ten European centers for a presumed endoscopically benign polyp unsuitable for endoscopic resection were retrospectively analyzed. The primary endpoint was morbidity. Secondary endpoints were operative time and length of hospital stay.Results: One hundred and ten patients were included: 25 patients underwent cecal wedge resection and 85 a right colectomy. There were 56 men (51%) and 90% of the procedures were performed laparoscopically.

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Primary adenocarcinoma of the appendix presenting with fresh bleeding per rectum: A case report

Sain¹,

Gupta²,

Bhattacharya³

et al. 2021

International Journal of Surgery Case Reports

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Introduction Primary adenocarcinoma of appendix is a rarely diagnosed malignancy accounting for less than 6% of appendiceal neoplastic lesions and less than 0.5% of all gastrointestinal malignancies. It is mostly diagnosed as an incidental finding after appendicectomy. Case summary An 81 year old male patient presented with bleeding per rectum in a background of previous rectal polyp, hypertension, diabetes and hypothyroidism. CECT of whole abdomen findings revealed thickening at the appendix and base of the caecum. Colonoscopy showed a sessile polypoid growth at appendicular orifice, at the base of the caecum. Laparoscopy confirmed the clinical suspicion of appendicular carcinoma and laparoscopy assisted radical right hemicolectomy was performed. Final histopathology revealed well differentiated adenocarcinoma of the appendix with no lymph node involvement (pT3N0M0). Discussion Patients with primary adenocarcinoma of the appendix present with features similar to acute appendicitis whereas anaemia or fresh bleeding per rectum is a rare presentation. Surgery is the mainstay of treatment, the extent of which will depend upon the stage. Tumours staged as T1 may be managed by appendicectomy alone provided the base is free and there are no lymphadenopathies. T2 or above require right hemicolectomy as chances of lymph node metastasis are high. Nodal involvement warrants the need for adjuvant chemotherapy. Distant metastasis to the peritoneum or liver and lungs is very rare. Conclusion While investigating unexplained anaemia or bleeding per rectum, full colonoscopic examination up to the appendicular orifice is important and if required, should be combined with CT scan of abdomen, to clinch the rare but possible and potentially curable diagnosis of appendicular carcinoma.

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Appendix orifice polyps: a study of 691 lesions at a single institution

Cited by 7 publications

References 12 publications

“Obscure” Appendiceal Orifice Polyps Can Be Challenging to Identify by Colonoscopy

“Obscure” Appendiceal Orifice Polyps Can Be Challenging to Identify by Colonoscopy

Ileocecal Valve Sparing Resection for the Treatment of Benign Cecal Polyps Unsuitable for Polypectomy

Primary adenocarcinoma of the appendix presenting with fresh bleeding per rectum: A case report

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