Shiki Fujino, Norikatsu Miyoshi, Shingo Noura, Masayuki Ohue, Masahiko Yano, Departments of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka-city, 558-8585 Osaka, Japan.
World J Gastrointest Surg. 2014 May 27;6(5):84-7. doi: 10.4240/wjgs.v6.i5.84.
In this case report, we discuss single-incision laparoscopic cecectomy for low-grade appendiceal neoplasm after laparoscopic anterior resection for rectal cancer. The optimal surgical therapy for low-grade appendiceal neoplasm is controversial; currently, the options include appendectomy, cecectomy, right hemicolectomy, and open or laparoscopic surgery. Due to the risk of pseudomyxoma peritonei, complete resection without rupture is necessary. We have encountered 5 cases of low-grade appendiceal neoplasm and all 5 patients had no lymph node metastasis. We chose the appendectomy or cecectomy without lymph node dissection if preoperative imaging studies did not suspect malignancy. In the present case, we performed cecectomy without lymph node dissection by single-incision laparoscopic surgery (SILS), which is reported to be a reduced port surgery associated with decreased invasiveness and patient stress compared with conventional laparoscopic surgery. We are confident that SILS is a feasible alternative to traditional surgical procedures for borderline tumors, such as low-grade appendiceal neoplasms.
在本病例报告中,我们讨论了经直肠前切除术治疗直肠癌后行单孔腹腔镜盲肠切除术治疗低级别阑尾肿瘤。低级别阑尾肿瘤的最佳手术治疗方法存在争议;目前的选择包括阑尾切除术、盲肠切除术、右半结肠切除术以及开腹或腹腔镜手术。由于存在腹膜假黏液瘤的风险,必须进行无破裂的完全切除。我们共遇到 5 例低级别阑尾肿瘤,所有患者均无淋巴结转移。如果术前影像学检查不怀疑恶性肿瘤,我们选择不进行淋巴结清扫的阑尾切除术或盲肠切除术。在本病例中,我们通过单孔腹腔镜手术(SILS)进行了无淋巴结清扫的盲肠切除术,与传统腹腔镜手术相比,SILS 被认为是一种减少了手术部位的手术,可减轻侵袭性和患者压力。我们相信,SILS 是一种可行的替代传统手术方法,适用于边界性肿瘤,如低级别阑尾肿瘤。