Lenriot J P, Huguier M
Ann Chir. 1989;43(9):744-51.
Thirty-two patients with primary adenocarcinoma of the appendix were studied in this collective review. Diagnosis was never suspected preoperatively. Immediate operation was performed in 21 patients with a diagnosis of acute appendicitis. At operation, tumor of the appendix was only identified in 50 percent of the 32 patients. One patient with an obstructing tumor and peritoneal involvement died postoperatively. Estimated survival rate was 46% at five years. Probability of survival was unrelated to the histologic tumor type but significantly correlated with the extent of tumor spread. Right hemicolectomy led to a significant increase in survival compared with appendectomy alone and to a significant decrease in risk of recurrence. In Dukes' B2 and C patients, differences in the survival curves were in favor of right hemicolectomy. In patients with pseudomyxoma peritonei, long-term survival was obtained by repeated laparotomy with resection of mucinous material. Our results indicate that, in good risk patients, right hemicolectomy performed as first or second operation, provides better results than appendectomy alone.
在这项综合回顾研究中,对32例原发性阑尾腺癌患者进行了研究。术前从未怀疑过诊断。21例诊断为急性阑尾炎的患者立即接受了手术。手术时,32例患者中只有50%被发现阑尾有肿瘤。1例患有阻塞性肿瘤并伴有腹膜受累的患者术后死亡。估计五年生存率为46%。生存概率与肿瘤的组织学类型无关,但与肿瘤扩散程度显著相关。与单纯阑尾切除术相比,右半结肠切除术可显著提高生存率,并显著降低复发风险。在Dukes' B2和C期患者中,生存曲线的差异有利于右半结肠切除术。在患有腹膜假黏液瘤的患者中,通过反复剖腹手术切除黏液物质可获得长期生存。我们的结果表明,对于风险较低的患者,作为首次或第二次手术进行的右半结肠切除术比单纯阑尾切除术效果更好。