原发性阑尾恶性肿瘤的诊治分析:附17例报告

Clinical diagnosis and treatment of 17 patients with primary appendix tumors

目的探讨原发性阑尾恶性肿瘤的临床特点、治疗方法及预后。方法回顾性分析东南大学医学院附属徐州医院1993年3月至2008年11月的17例原发性阑尾恶性肿瘤的临床和病理资料。结果所有患者无一例术前确诊,均在术中及术后病理确诊,其中黏液腺癌6例,类癌9例,恶性淋巴瘤2例。3例术中快速病理回报后行右半结肠切除术,13例患者术后3<d天再次手术,均行右半结肠切除术。1例行回肠双腔造瘘术。结论阑尾肿瘤临床少见且无特异性症状,术前诊断困难,对术中可疑肿瘤患者,应行术中快速病理检查,对术后提示为阑尾恶性肿瘤患者,应及时再次手术治疗。

Objective To summarize the clinical features, diagnosis and prognosis of primitive appendix tumor. Methods The clinical and pathologic data of 17 patients with primitive appendix tumor treated in our hospital from March 1993 to November 2008 were retrospectively analyzed. Results No one was given a certain diagnosis before operation. The pathology was diagnosed during or after the operation. Among the 17 cases, 6 cases belonged to mucinous adenocarcinoma, 9 cases carcinoid, and the rest 2 cases malignant lymphoma. Three patients were treated by right hemicolectomy after a rapid pathological analysis during the operation. Other 13 patients were given the right hemicolectomy 3 to 7 days after the first operation. The rest one case was given a double barrel ileostomy. Conclusions The appendix tumor is clinically rare. The patients may show atypical symptoms and signs. It is difficult to make an exact preoperative diagnosis. Rapid intraoperative pathological examination should be made when there is a probable appendix tumor. Another surgical operation should be given once after the malignant appendix tumor is diagnosed.