原发性阑尾恶性肿瘤的诊断和外科治疗(附15例报道)

The Diagnosis and Surgical Treatment of Appendiceal Neoplasm in 15 Patients

目的探讨原发性阑尾恶性肿瘤的诊断和外科治疗方法。方法回顾性分析15例经病理确诊并手术的原发性阑尾恶性肿瘤资料。典型类癌6例,杯状细胞类癌1例;阑尾粘液腺癌4例,中分化腺癌2例,粘液囊腺癌2例。术前确诊1例杯状细胞类癌,行右半结肠切除+腹腔化疗;术中确诊7例,其中2例典型类癌、1例粘液腺癌和1例粘液囊腺癌行阑尾及肿瘤切除术,1例典型类癌、1例粘液囊腺癌及1例腺癌行右半结肠切除术;术后明确诊断7例,2例典型类癌未再行手术治疗,1例典型类癌、4例腺癌行补救性右半结肠切除术。结果所有患者平均随访32(4~98)月。11例无症状生存,3例腺癌和1例杯状细胞类癌在术后15月内死亡。结论阑尾恶性肿瘤术前确诊困难,术中确诊并选择合理术式是保证预后的重要手段。

Objective To explore the diagnosis and surgical treatment of primary appendiceal malignant tumors. Methods The clinical data of 15 patients with primary appendiceal malignant tumors treated by operations was analyzed retrospectively.There were 6 patients diagnosed typical carcinoid,1 goblet-cell carcinoid,4 mucinous adenocarcinoma,2 moderately differentiated adenocarcinoma,and 2 mucinous cystadenocarcinoma.The case with goblet-cell carcinoid was diagnosed pathologically before operation,and was done with ri...