Appendix tumors in the era of laparoscopic appendectomy

Bucher, Pascal Alain Robert; Máthé, Z.; Demi̇rağ, A; Morel, Philippe

doi:10.1007/s00464-003-9255-x

Cited by 83 publications

(76 citation statements)

References 15 publications

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“…Appendix carcinoids are relatively indolent neoplasms, rarely associated with carcinoid syndrome [16,20], that are usually discovered in association with acute appendicitis [3,8], as was the case in 64% of our patients. Diagnosis is usually done either during operation or mainly during pathological examination of the resected appendix [2,8], which is corroborated by our results.…”

Section: Discussionsupporting

confidence: 87%

“…Patients treated for appendix carcinoid have an increased risk of second cancer [2,8,15,20,21], which was the case in 18% of our patients. The increased risk of second cancer in patients with carcinoid may be related to a genetic predisposition to certain cancer, including neuroendocrine and nonneuroendocrine tumors [21].…”

Section: Discussionmentioning

confidence: 64%

“…Although a literature search found a few cases of appendix carcinoid resection via laparoscopy [1,2,12], it has never been compared to open appendectomy [7]. Heller et al [12] reported a small series of such resections during laparoscopy for gynecologic indications and concluded that this technique could be suitable for incidentally discovered appendix carcinoid.…”

Section: Discussionmentioning

confidence: 99%

“…Although our data suggest that the prognosis of patients treated for appendix carcinoid is similar after laparoscopic and open appendectomy, diagnostic confirmation is seldom available before pathological examination of the specimen. It must be acknowledged that experience with the laparoscopic resection of appendix cancer is mostly anecdotic [2], and the risk of type II error, in relation to the rarity of this pathology as well as the small incidence of tumor recurrence or progression after surgery, could not be neglected. Therefore, we continue to recommend open appendectomy in the case of preoperative suspicion of appendix cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Some of these patients have been previously reported in a paper relating to appendix tumors [2]. Laparoscopic (three-trocar technique) and open appendectomies were performed according to standard hospital techniques.…”

Section: Methodsmentioning

confidence: 99%

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Laparoscopic versus open resection for appendix carcinoid

et al. 2006

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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.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Laparoscopic versus open resection for appendix carcinoid

et al. 2006

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Increased Risk of Mucinous Neoplasm of the Appendix in Adults Undergoing Interval Appendectomy

et al. 2013

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Right Iliac Fossa Pain

et al. 2013

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A 32-year-old woman presented to the hospital complaining about having colicky abdominal pain for the last 2 weeks. The pain was usually generalized but sometimes radiated to the right iliac fossa. The pain got worse with meals and was associated with nausea but no vomiting. In the last 2 days, the pain was associated with loose stools, but there was no mucus or blood. She had no comorbidities, such as diabetes mellitus or hypertension, and no previous admission to the hospital. She is married and has 4 children; her last child was born 40 days prior to her presentation to the hospital. On examination, her vital signs were normal (temperature, 37.1°C; pulse, 86 beats/min; and blood pressure, 121/86 mm Hg). Her abdomen was soft and lax. There was mild tenderness in the right iliac fossa, but no lump or lumps were felt. Bowel sounds were not exaggerated. Her white blood cell count was 8500/μL (to convert to ×10 9 per liter, multiply by 0.001), her hemoglobin level was 1.3 g/dL (to convert to grams per liter, multiply by 10.0), and her platelet count was 361 × 10 3 /μL (to convert to ×10 9 per liter, multiply by 1.0). The results of renal and liver function tests were normal. Abdominal ultrasonography revealed a 4.2 × 4.2-cm mass in the midabdominal region lateral to the gall bladder fossa. The mass has the "donut sign" with central echogenicity ( Figure 1A). An abdominal computed tomographic scan ( Figure 1B) showed a 8.2 × 4 × 2.6-cm tubular thin-walled filling defect in the cecum and lower part of ascending colon. The oral contrast agent can be seen around, proximal, and distal to the defect, with no obstruction noted.

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Appendix tumors in the era of laparoscopic appendectomy

Abstract: 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.

Cited by 83 publications

References 15 publications

Laparoscopic versus open resection for appendix carcinoid

Laparoscopic versus open resection for appendix carcinoid

Increased Risk of Mucinous Neoplasm of the Appendix in Adults Undergoing Interval Appendectomy

Right Iliac Fossa Pain

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