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[阑尾类癌意外发现的手术策略]

[Surgical strategies for accidental detection of appendix carcinoids].

作者信息

Dralle H

机构信息

Universitätsklinik und -Poliklinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Halle (Saale), Medizinische Fakultät der Martin-Luther-Universität Halle, Ernst-Grube-Strasse 40, Halle, Germany.

出版信息

Chirurg. 2011 Jul;82(7):598-606. doi: 10.1007/s00104-011-2071-2.

Abstract

Carcinoids (neuroendocrine tumors NET) of the appendix are rare tumors and even today mostly detected only postoperatively by histopathology following operations for acute appendicitis or other abdominal procedures. Most NETs of the appendix are located at the tip of the appendix, less than 2 cm in size and non-metastasizing. Secondary right hemicolectomy with lymph node dissection bears a considerable risk of complications compared to simple appendectomy. To decide upon secondary surgery histopathological risk factors, such as grading, invasion of the mesoappendix, and tumor type in addition to tumor localization and size should be taken into consideration. Up to 20% of NETs of the appendix are associated with various neoplasms of the gastrointestinal tract. Follow-up examination should therefore also consider both appendix carcinoids and synchronous or metachronous neoplasms of the gastrointestinal tract.

摘要

阑尾类癌(神经内分泌肿瘤NET)是罕见肿瘤,即便在如今,大多也只是在因急性阑尾炎或其他腹部手术切除阑尾后,通过组织病理学检查才在术后被发现。阑尾的大多数NET位于阑尾尖端,大小小于2厘米,且无转移。与单纯阑尾切除术相比,二期右半结肠切除术加淋巴结清扫术有相当大的并发症风险。决定是否进行二期手术时,除了肿瘤的定位和大小外,还应考虑组织病理学危险因素,如分级、阑尾系膜侵犯情况和肿瘤类型。高达20%的阑尾NET与胃肠道的各种肿瘤有关。因此,随访检查还应兼顾阑尾类癌以及胃肠道的同步或异时性肿瘤。

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