Department of Public Health, University of Naples Federico II, Naples, Italy.
Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
Surgeon. 2021 Dec;19(6):e549-e558. doi: 10.1016/j.surge.2021.01.010. Epub 2021 Feb 25.
Non-operative management is often the treatment of choice in cases of complicated appendicitis and routine interval appendectomy is not usually recommended. Actually, recent studies show an alarming number of appendiceal neoplasms following interval appendectomy. The aim of this study is to evaluate the prevalence of appendiceal neoplasms and their histological types after interval appendectomy for complicated appendicitis in adults.
A comprehensive literature search of the PubMed, Scopus and Web of Science databases was conducted according to the PRISMA statement. Studies reporting appendiceal neoplasm rates after interval appendectomy and histopathological characteristics were included. The most recent World Health Organization (WHO) classification of malignant tumours was considered. A pooled prevalence analysis for both prevalence and pathology was performed.
A total of eight studies was included: seven retrospective series and one randomized controlled trial. The pooled prevalence of neoplasms after interval appendectomy was 11% (95% CI 7-15; I = 37.5%, p = 0.13). Appendiceal mucinous neoplasms occurred in 43% (95% CI 19-68), adenocarcinoma in 29% (95% CI 6-51), appendiceal neuroendocrine neoplasm in 21% (95% CI 6-36), globet cell carcinoma in 13% (95% CI -2-28), adenoma or serrated lesions in 20% (95% CI -0-41) of cases.
The risk of appendiceal neoplasm in patients treated with interval appendectomy for complicated appendicitis is 11%; mucinous neoplasm is the most common histopathological type. Further studies should investigate this association in order to clarify the biological pathway and clinical implications.
非手术治疗通常是复杂阑尾炎的治疗选择，通常不建议常规间隔阑尾切除术。实际上，最近的研究表明，在间隔阑尾切除术后会出现大量阑尾肿瘤。本研究旨在评估成人复杂阑尾炎间隔阑尾切除术后阑尾肿瘤的发生率及其组织学类型。
根据 PRISMA 声明，对 PubMed、Scopus 和 Web of Science 数据库进行了全面的文献检索。纳入报告间隔阑尾切除术后阑尾肿瘤发生率和组织病理学特征的研究。采用最新的世界卫生组织（WHO）恶性肿瘤分类。对两种患病率（患病率和病理学）进行汇总分析。
共纳入 8 项研究：7 项回顾性系列研究和 1 项随机对照试验。间隔阑尾切除术后肿瘤的总患病率为 11%（95%CI 7-15；I = 37.5%，p = 0.13）。阑尾黏液性肿瘤占 43%（95%CI 19-68），腺癌占 29%（95%CI 6-51），阑尾神经内分泌肿瘤占 21%（95%CI 6-36），类癌占 13%（95%CI -2-28），腺瘤或锯齿状病变占 20%（95%CI -0-41）。
接受间隔阑尾切除术治疗复杂阑尾炎的患者发生阑尾肿瘤的风险为 11%；黏液性肿瘤是最常见的组织病理学类型。需要进一步研究以阐明这种关联的生物学途径和临床意义。
