Wright Gerald Paul, Mater Megan E, Carroll Joseph T, Choy Jennifer S, Chung Mathew H
Grand Rapids Medical Education Partners, General Surgery Residency Program, Grand Rapids, MI, USA; Michigan State University College of Human Medicine, Department of Surgery, Grand Rapids, MI, USA.
Grand Rapids Medical Education Partners, General Surgery Residency Program, Grand Rapids, MI, USA; Michigan State University College of Human Medicine, Department of Surgery, Grand Rapids, MI, USA.
Am J Surg. 2015 Mar;209(3):442-6. doi: 10.1016/j.amjsurg.2014.09.020. Epub 2014 Dec 11.
The rate of recurrent appendicitis is low following nonoperative management of complicated appendicitis. However, recent data suggest an increased rate of neoplasms in these cases.
The study was a retrospective review of patients with acute appendicitis at 2 university-affiliated community hospitals over a 12-year period. The primary outcome measure was the incidence of appendiceal neoplasm following interval appendectomy.
Six thousand thirty-eight patients presented with acute appendicitis. Appendectomy was performed in 5,851 (97%) patients at the index admission. Of the 188 patients treated with initial nonoperative management, 89 (47%) underwent interval appendectomy. Appendiceal neoplasms were identified in 11 of the 89 (12%) patients. These included mucinous neoplasms (n = 6), carcinoid tumors (n = 4), and adenocarcinoma (n = 1). The rate of neoplasm in patients over age 40 was 16%.
There is a significant rate of neoplasms identified in patient over age 40 undergoing interval appendectomy. This should be considered following nonoperative management of complicated appendicitis.
复杂阑尾炎非手术治疗后复发性阑尾炎的发生率较低。然而，最近的数据表明这些病例中肿瘤的发生率有所增加。
该研究是对2所大学附属医院在12年期间急性阑尾炎患者的回顾性分析。主要结局指标是间隔期阑尾切除术后阑尾肿瘤的发生率。
6038例患者表现为急性阑尾炎。初次入院时5851例（97%）患者接受了阑尾切除术。在188例最初接受非手术治疗的患者中，89例（47%）接受了间隔期阑尾切除术。89例患者中有11例（12%）发现阑尾肿瘤。其中包括黏液性肿瘤（n = 6）、类癌肿瘤（n = 4）和腺癌（n = 1）。40岁以上患者的肿瘤发生率为16%。
40岁以上接受间隔期阑尾切除术的患者中肿瘤发生率较高。复杂阑尾炎非手术治疗后应考虑这一点。
