Bowman G A, Rosenthal D
Am J Surg. 1983 Dec;146(6):700-3. doi: 10.1016/0002-9610(83)90321-5.
The data presented in this series support the premise that simple appendectomy is adequate therapy for appendiceal carcinoids less than 1 cm in diameter. However, little argument can be made against more radical surgery for gross lymph node metastases. When surgical margins after appendectomy are not free of tumor, additional surgery seems warranted, although in the present series there was a patient who was followed for 30 years who had residual microscopic disease in the appendiceal stump. Adequate treatment for tumors larger than 2 cm includes radical right hemicolectomy. What constitutes adequate therapy for tumors in the 1 to 2 cm range continues to be a point of controversy. From the data presented herein, it seems that appendectomy alone is sufficient except in those instances when both mesoappendiceal and subserosal lymphatic invasion is identified microscopically.
本系列所呈现的数据支持这样一个前提，即对于直径小于1厘米的阑尾类癌，单纯阑尾切除术是足够的治疗方法。然而，对于出现明显淋巴结转移的情况，采用更激进的手术方式也无可厚非。当阑尾切除术后手术切缘有肿瘤残留时，似乎有必要进行额外的手术，尽管在本系列中有一名患者阑尾残端有微小残留病灶，仍随访了30年。对于直径大于2厘米的肿瘤，充分的治疗包括根治性右半结肠切除术。对于直径在1至2厘米范围内的肿瘤，何种治疗方法才算充分仍是一个有争议的问题。从本文所呈现的数据来看，似乎除非在显微镜下发现阑尾系膜和浆膜下淋巴管均有浸润的情况，否则单纯阑尾切除术就足够了。
