Temesi Rita, Bezsilla János, Botos Akos, Sikorszki László, Berecz János, Pap Tímea, Ludvig Zsuzsanna, Bende Sándor
Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház, Altalános Sebészeti Osztály, 3532 Miskolc, Szent Imre tér 9/b.
Magy Seb. 2008 Feb;61(1):24-8. doi: 10.1556/MaSeb.61.2008.1.5.
Mucocele is a mucin-filled cavity, which can be multi-loculated as well. Mucocele is relatively rarely found in the appendix. The disease does not cause any symptoms in most cases, and it is usually an accidental finding. A thorough investigation should be carried out to exclude malignancy. Depending on the operative findings and the full histological report, the spectrum of surgery extends from appendectomy to right hemicolectomy. In this paper, we discuss the presentation, diagnostical options, and the possible surgical treatment--based on our experience with five cases. In three cases a non-tender mass was palpable in the right lower quadrant of the abdomen, while another patient presented with right lower quadrant abdominal pain and one with abdominal pain and diarrhoea. Abdominal and pelvic ultrasound and CT scans raised the possibility of mucocele, however colonoscopy was negative. After laparoscopic exploration, laparoscopy assisted partial caecum resection was carried out in two cases, in further two cases laparoscopic appendectomy, and in one case laparoscopic partial caecum resection was done. The hystological examinations showed appendiceal mucocele with no malignancy demonstrated. All patients recovered without complications, they were discharged from hospital on postoperative day five. The patients have been disease free after a 6-30 month follow-up period. We concluded that laparoscopy is a recommended method for the surgery of appendiceal mucocele.
黏液囊肿是一个充满黏液的腔隙,也可为多房性。黏液囊肿在阑尾中相对少见。该病在大多数情况下不引起任何症状,通常为偶然发现。应进行全面检查以排除恶性肿瘤。根据手术所见及完整的组织学报告,手术范围从阑尾切除术到右半结肠切除术。在本文中,我们基于5例病例的经验,讨论其临床表现、诊断方法及可能的手术治疗。3例患者在右下腹可触及无痛性肿块,另1例患者表现为右下腹疼痛,还有1例患者表现为腹痛和腹泻。腹部及盆腔超声和CT扫描提示黏液囊肿的可能性,但结肠镜检查为阴性。经腹腔镜探查后,2例行腹腔镜辅助部分盲肠切除术,2例行腹腔镜阑尾切除术,1例行腹腔镜部分盲肠切除术。组织学检查显示为阑尾黏液囊肿,未发现恶性病变。所有患者均康复,无并发症发生,术后第5天出院。经过6至30个月的随访期,患者均无疾病复发。我们得出结论,腹腔镜手术是阑尾黏液囊肿手术的推荐方法。