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腹腔镜下切除偶然发现的阑尾黏液囊肿:这样做正确吗?病例报告。

Laparoscopic resection of an incidental appendiceal mucocele: is it correct. Case report.

作者信息

Cartanese Carmine, Petitti Tommaso, Ferrozzi Lucio

机构信息

Department of General Surgery, Masselli-Mascia Hospital, Foggia, Italy.

出版信息

Ann Ital Chir. 2012 Jul-Aug;83(4):359-62.

Abstract

Mucocele of the appendix is an uncommon disorder, characterized by a cystic dilatation of the lumen; it's mainly due to mucinous cystadenoma. Definite diagnosis is difficult preoperatively. It can be discovered incidentally at laparotomy or laparoscopy performed for other reason. Treatment consist in complete resection avoiding rupture of the cyst in the peritoneal cavity. Indeed, rupture of the lesion either spontaneous or accidental, during surgery may result in the clinical condition of pseudomyxoma peritonei. Therefore, open approach is recommended for the surgical treatment of these lesions. The role of laparoscopic surgery in the management of appendiceal mucocele remains controversial. We report a case of mucous cystadenoma of the appendix, successfully removed during a laparoscopy for perforated peptic ulcer, which was well at a 12-month follow-up. Laparoscopic appendectomy is not contraindicated in mucocele of appendix, if appropriate precautions can be taken intraoperatively.

摘要

阑尾黏液囊肿是一种罕见的疾病,其特征为管腔的囊性扩张;主要由黏液性囊腺瘤引起。术前明确诊断较为困难。它可在因其他原因进行剖腹手术或腹腔镜检查时偶然发现。治疗方法是完整切除,避免囊肿在腹腔内破裂。实际上,病变无论是自发破裂还是在手术中意外破裂,都可能导致腹膜假黏液瘤的临床状况。因此,建议采用开放手术方法治疗这些病变。腹腔镜手术在阑尾黏液囊肿治疗中的作用仍存在争议。我们报告一例阑尾黏液性囊腺瘤,在因消化性溃疡穿孔进行腹腔镜手术时成功切除,术后12个月随访情况良好。如果术中能采取适当的预防措施,腹腔镜阑尾切除术在阑尾黏液囊肿中并非禁忌。

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