Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 No. 7-14, Bogotá, DC, Colombia.
School of Medicine, Universidad de los Andes, Cundinamarca, Colombia.
BMC Surg. 2023 Sep 21;23(1):287. doi: 10.1186/s12893-023-02183-4.
Non-operative management has been suggested as a therapy for uncomplicated appendicitis. Notwithstanding, the risk of missing an appendiceal tumor must be considered, being the surgical piece crucial to rule out neoplasms. Therefore, we aim to determine the incidence of appendiceal neoplasms in patients with acute appendicitis, tumor types and the importance of the anatomopathological study of the surgical piece.
Retrospective study in which we described patients who underwent emergent appendectomy with histopathological findings of appendiceal neoplasms from January 2012 to September 2018. Descriptive analysis included demographic variables, diagnostic methods, and surgical techniques.
2993 patients diagnosed with acute appendicitis who underwent an emergency appendectomy. 64 neoplasms of the appendix were found with an incidence of 2,14%. 67.2% were women, the mean age was 46,4 years (± 19.5). The most frequent appendiceal neoplasms were neuroendocrine tumors (42,2%), followed by appendiceal mucinous neoplasms (35,9%), sessile serrated adenomas (18,8%), and adenocarcinomas (3,1%). In 89,1% of the cases, acute appendicitis was determined by imaging, and 14% of cases were suspected intraoperatively. Appendectomy was performed in 78,1% without additional procedures.
Appendiceal tumors are rare and must be ruled out in patients with suspected acute appendicitis. The incidence of incidental neoplasms is higher in this study than in the previously reported series. This information must be included in decision-making when considering treatment options for acute appendicitis.
非手术治疗已被建议用于治疗单纯性阑尾炎。然而，必须考虑到漏诊阑尾肿瘤的风险，因为手术切除的阑尾组织对于排除肿瘤至关重要。因此，我们旨在确定急性阑尾炎患者中阑尾肿瘤的发生率、肿瘤类型以及手术切除组织的解剖病理研究的重要性。
这是一项回顾性研究，我们描述了 2012 年 1 月至 2018 年 9 月期间因阑尾组织病理学检查发现阑尾肿瘤而行急诊阑尾切除术的患者。描述性分析包括人口统计学变量、诊断方法和手术技术。
共诊断出 2993 例急性阑尾炎患者，其中 64 例阑尾肿瘤的发生率为 2.14%。女性占 67.2%，平均年龄为 46.4 岁（±19.5 岁）。最常见的阑尾肿瘤是神经内分泌肿瘤（42.2%），其次是阑尾黏液性肿瘤（35.9%）、无蒂锯齿状腺瘤（18.8%）和腺癌（3.1%）。在 89.1%的病例中，通过影像学检查确定为急性阑尾炎，14%的病例在术中怀疑。78.1%的患者行阑尾切除术，无附加手术。
阑尾肿瘤罕见，在疑似急性阑尾炎患者中必须排除。在本研究中，偶然发现的肿瘤发生率高于先前报道的系列研究。在考虑急性阑尾炎的治疗方案时，必须将这些信息纳入决策过程。
