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[阑尾类癌肿瘤:何时行右半结肠切除术?]

[Carcinoid tumors of the appendix: when right colectomy?].

作者信息

Fornaro R, Picori E, Stabilini C, Frascio M, Sticchi C, Boccardo C, Ricci B, Giannetta E

机构信息

Dipartimento di Discipline Chirurgiche e Metodologie integrate, Università degli Studi di Genova.

出版信息

G Chir. 2006 May;27(5):233-9.

Abstract

Three cases of carcinoid tumour of the appendix (about 0,3 % of all performed appendectomies) has induced the Authors to a review of the literature with the aim to underline the most important biological and pathological findings and the current clinic and therapeutic knowledges. The diagnosis before surgery is rarely made; it is formulated incidentally in most patients by the histological exam during the operation for an appendicitis or during other surgical procedures. The kind of surgical intervention, that is the entity of the surgical demolition, for the treatment of the carcinoid tumours of the appendix is still controversial: appendectomy or right colectomy? It is possible identify, also during the operation for an appendicitis or for other abdominal lesions, criteria that can orient toward a major surgery (size of the neoplasia, subserosal lymphatic invasion, infiltration of the serosa, diffusion in the meso-appendix, location in closeness of the base of the appendix, invasion of the the locoregional lymph nodes, presence of metastases, section ?margins, number of mitoses, cellular pleiomorfism).

摘要

三例阑尾类癌肿瘤(约占所有阑尾切除术的0.3%)促使作者对文献进行回顾,目的是强调最重要的生物学和病理学发现以及当前的临床和治疗知识。术前很少能做出诊断;大多数患者是在因阑尾炎进行手术或其他外科手术过程中通过组织学检查偶然确诊的。对于阑尾类癌肿瘤的治疗,手术干预方式,即手术切除范围,仍存在争议:是做阑尾切除术还是右半结肠切除术?在因阑尾炎或其他腹部病变进行手术时,也有可能确定一些标准,以指导是否进行更大范围的手术(肿瘤大小、浆膜下淋巴管浸润、浆膜浸润、阑尾系膜扩散、阑尾根部附近位置、区域淋巴结侵犯、转移情况、切缘、有丝分裂数量、细胞多形性)。

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