阑尾黏液囊肿的诊断及外科治疗（附6例报告）

Diagnosis and surgical treatment of appendiceal mucocele （ A report of 6 cases）

目的 探讨阑尾黏液囊肿的诊断、手术治疗方法及临床效果. 方法 回顾性分析2007年4 月至2013年9月吉林油田总医院收治的6例阑尾黏液囊肿患者的临床资料,结合相关文献对阑尾黏液囊肿的诊断及手术治疗方法进行总结.结果 本研究患者术前误诊4例,误诊率为66.7%. 囊肿位于阑尾远端4例,中远端2例,形态呈椭圆形腊肠样,内容物为黄白色胶冻样物,4例常规切除阑尾、系膜及囊肿,2例行回盲部切除及回结肠端端吻合术. 术后病理诊断阑尾黏液囊肿4例,阑尾黏液潴留2例,术后无明显并发症发生,随访1-3年未见囊肿复发及转移. 结论 阑尾黏液囊肿临床表现不典型,术前误诊率极高,临床医生应提高对本病的认识,术中细致操作,对恶变可疑者及时快速冰冻病理切片检查,根据病例结果选择合适术式,可提高治疗效果.

Objective To investigate the diagnosis, operative treatment and clinical effect of appendiceal mucocele. Methods The clinical data of 6 patients with appendiceal mucocele from April 2007 to September 2013 were retrospectively ana-lyzed.The diagnosis and operative treatment of appendiceal mucocele was summarized combined with pertinent literature .Re-sults Four patients were misdiagnosed before the operation and the misdiagnosis rate was 66.7%.There were 4 patients with the cysts on the remote of their epityphlon, 2 patients with cysts on the central of their epityphlon, the cysts form were oval, liked sausages and with yellowish white jelly contents in them.Four patients were cut the epityphlons, mesenteries and cysts by con-ventional operation, and two patients were treated with resection of ileocecum combined the end-to-side anastomosis of ileocolon. After the operation, there were 4 patients diagnosed as appendiceal mucocele by pathological diagnosis, 2 patients diagnosed as appendiceal mucus tumor, and there were no obviously complication occurred , follow-up visited for 1 to 3 years, the cyst did not reappear or transfer.Conclusions The clinical manifestation of appendiceal mucocele is atypical, the misdiagnosis rate before the operation is too high and clinicians should enhance their notice on this disease, operate carefully during the operation;as to the patients with suspicious malignant transformation , frozen their pathological section in time and examine as soon as possible , then choose the suitable operation, thus enhance the therapeutic effect.