- 期刊
Abnormality of Appendix in Incidental Appendectomy during Colorectal Cancer Surgery
附帶闌尾切除於大腸直腸癌症手術之異常闌尾發現
摘要
目的 附帶闌尾切除於大腸直腸手術一直以來是很常執行但非常規術式。本研究的目的主要是藉由大腸直腸癌患者接受附帶闌尾切除之後，分析闌尾異常病理發現的發生率來決定其臨床意義。方法 回溯性收集自2003年至2012年被診斷大腸直腸癌並接受癌症切除手術合併附帶闌尾切除的病人，我們共分析及回顧1375個闌尾病理切片結果。結果 這篇研究總共收集1375位病人，平均年齡為61±12歲（20-94歲）。在這些病人當中我們發現，其中有58.8%為男性，有6.91%（95位）有闌尾糞石，有0.36%（5位）是神經內分泌瘤，0.15%（2位）是黏液性囊腺瘤，0.87%（12位）是闌尾的大腸直腸癌同時性轉移。總共有240位病人（17.45%）的闌尾為異常病理發現，這當中有19位病人（1.38%）為闌尾腫瘤（Neoplasm）。在所有接受附帶闌尾切除的病人當中，並未發現有任何相關併發症。結論 附帶闌尾切除於大腸直腸癌手術當中是個安全的術式而且也許可以減少闌尾腫瘤的發生率及避免日後闌尾發炎。我們建議接受大腸直腸癌手術的病人應該同時接受附帶闌尾切除，因為同時性的闌尾腫瘤發生率並不是罕見（1.38%）。異時性轉移腫瘤相對於保留闌尾的病人來說也是一個風險。闌尾糞石於急性闌尾炎中扮演致病因子之一，而且與發生複雜性闌尾炎有關。總結上述結果，附帶闌尾切除對於接受大腸直腸癌手術的病人可能是有利的。
並列摘要
Purpose. Incidental appendectomy is a frequent but non-standard procedure during colorectal surgery. The purpose of this study was to evaluate the incidence of abnormal pathological findings of appendix in incidental appendectomy during colorectal cancer surgery and to determine its clinical significance. Methods. A retrospective review of patients who were diagnosed with colorectal cancer and underwent oncological resection of the tumor together with incidental appendectomy at the department of colorectal surgery of our hospital between 2003 and 2012. The histological findings of 1,375 cases of incidental appendectomies during colorectal cancer surgery were analyzed and reviewed. Results. This study included 1,375 patients with a mean age of 61 ± 12 years (range 20-94). Among them, 58.8% were male, 6.91% (95 patients) had fecalith, 0.36% (5 patients) had neuroendocrine tumor, 0.15% (2 patients) had mucinous cystadenoma and 0.87% (12 patients) had synchronous metastatic colorectal cancer in the appendix. Abnormal pathologic alteration was found in 240 patines (17.45%) and a neoplasm was found in 19 patients (1.38%). No complication occurred from the incidental appendectomy. Conclusions. Incidental appendectomy is a safe procedure and may be performed with colorectal cancer surgery to reduce the incidence of appendiceal neoplasm and prevent appendicitis in the future. Patient having colorectal carcinoma should undergo incidental appendectomy because the incidence of synchronous appendiceal neoplasm is not rare (1.38 percent). Metachronous neoplasm is a risk in the retained appendix in patients with colorectal cancer. Appendiceal fecaliths appear to play a role in the pathogenesis of acute appendicitis and are associated with complicated appendicitis. In conclusion, incidental appendectomy may be beneficial for patients undergoing colorectal cancer surgery.