Palanivelu Chinnusamy, Rangarajan Muthukumaran, Annapoorni Shankar, Senthilkumar Rangaswamy, Anand Natesan V
Department of Minimal Access Surgery, GEM Hospital & Postgraduate Institute, Coimbatore, India.
J Laparoendosc Adv Surg Tech A. 2008 Jun;18(3):417-21. doi: 10.1089/lap.2007.0132.
Tumors of the appendix are rare entities, and the majority of them are discovered accidentally during an investigation for other conditions. Laparoscopic surgery for appendiceal goblet-cell carcinoid (GCC) has only been reported once before. Our patient was incidentally discovered to have an appendiceal tumor and was referred to us for laparoscopy. The tumor involved the body of the appendix and was adherent to the cecum. A laparoscopic hemicolectomy was successfully performed for the patient. Postoperative recovery was uneventful. Histopathology confirmed an appendiceal goblet-cell carcinoid. Immunohistochemistry was negative for the neuroendocrine markers, CK20 and CK7. GCC is a rare tumor of the appendix. Hemicolectomy is indicated in specific situations, such as local involvement or tumor size >2 cm. In our patient, the tumor was adherent to the cecum and tumor size was 5 cm. Therefore, a laparoscopic right hemicolectomy was performed primarily. There are several reports in the literature supporting both the laparoscopic and open approaches. Laparoscopic surgery for appendiceal tumors is safe, feasible, and even may be beneficial.
阑尾肿瘤是罕见的疾病,大多数是在因其他病症进行检查时偶然发现的。此前仅有一例关于腹腔镜手术治疗阑尾杯状细胞类癌(GCC)的报道。我们的患者偶然发现患有阑尾肿瘤,并被转诊至我们这里接受腹腔镜检查。肿瘤累及阑尾体部并与盲肠粘连。为该患者成功实施了腹腔镜半结肠切除术。术后恢复顺利。组织病理学确诊为阑尾杯状细胞类癌。免疫组化显示神经内分泌标志物CK20和CK7呈阴性。GCC是一种罕见的阑尾肿瘤。在特定情况下,如局部受累或肿瘤大小>2 cm时,需行半结肠切除术。在我们的患者中,肿瘤与盲肠粘连且肿瘤大小为5 cm。因此,首先进行了腹腔镜右半结肠切除术。文献中有多篇报道支持腹腔镜和开放手术两种方法。腹腔镜手术治疗阑尾肿瘤是安全、可行的,甚至可能有益。