Harris Banks Ford, Collins Camron Noah, Gerard Justin D
College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham Street #550, Little Rock, AR 72205, United States.
Department of Surgery, Graduate School of Medicine, University of Tennessee Knoxville, 1924 Alcoa Highway, Box U-11, Knoxville, TN 37920, United States.
J Surg Case Rep. 2025 Apr 30;2025(5):rjaf259. doi: 10.1093/jscr/rjaf259. eCollection 2025 May.
The optimal management of appendiceal orifice (AO) tumors remains a topic of debate due to their anatomical complexity and the absence of a standardized surgical approach. This case report describes the successful treatment of an incompletely resected sessile serrated lesion at the AO in a 47-year-old female using a multidisciplinary strategy. Preoperative imaging, gastroenterology consultation, and intraoperative specimen evaluation guided a laparoscopic appendectomy with cecal cuff resection, achieving complete tumor removal with minimal morbidity. This approach preserved ileocecal valve function and ensured accurate pathological assessment. This case highlights key considerations, including the importance of avoiding ileocecal valve compromise and ensuring polyp retrieval for definitive pathological assessment. We propose appendectomy with cecal cuff resection as a standardized, effective technique to reduce treatment variability and mitigate incomplete resection risks in AO tumors.
由于阑尾开口(AO)肿瘤的解剖结构复杂且缺乏标准化的手术方法,其最佳治疗方案仍是一个有争议的话题。本病例报告描述了一名47岁女性,采用多学科策略成功治疗了AO处未完全切除的无蒂锯齿状病变。术前影像学检查、胃肠病学会诊和术中标本评估指导了腹腔镜阑尾切除术并切除盲肠袖口,以最小的发病率实现了肿瘤的完全切除。这种方法保留了回盲瓣功能,并确保了准确的病理评估。该病例突出了关键考虑因素,包括避免回盲瓣受损以及确保取出息肉进行明确病理评估的重要性。我们建议阑尾切除术并切除盲肠袖口作为一种标准化、有效的技术,以减少治疗差异并降低AO肿瘤不完全切除的风险。