摘要
目的 探讨阑尾腺癌的临床特点及诊治原则。方法 回顾性分析2010年1月至2020年12月华中科技大学同济医学院附属协和医院收治的5例阑尾腺癌病人的临床资料。结果 5例病人中有3例初诊为急性阑尾炎,一期行阑尾切除术,二期行右半结肠根治术;2例术前诊断为回盲部占位性病变,肠镜取活检确诊为阑尾腺癌,一期行右半结肠根治术。5例病人中结肠型腺癌2例(中分化),黏液腺癌2例(中分化),杯状细胞腺癌1例(中分化)。结论 阑尾腺癌在临床上极为少见,缺乏特异性症状,术前诊断困难,术前CT和肠镜检查有助于确诊,右半结肠根治术是常规手术方式,对侵犯浆膜的肿瘤术中、术后可行腹腔热灌注化疗,术后应根据分期辅以化疗。
Objective To explore the clinical features,diagnoses and treatments of appendiceal adenocarcinoma(AA).Methods The relevant clinical data were retrospectively reviewed for 5 hospitalized AA patients.Results Among them,3 cases were diagnosed as acute appendicitis at the first time,one-stage appendectomy was performed,second-stage right hemicolectomy was performed,2 cases were diagnosed as ileocecal space-occupying lesions before operation,enteroscopic biopsy was performed for diagnosing appendiceal adenocarcinoma,and first-stage right hemicolectomy was performed.Among the 5 patients,colonic adenocarcinoma(moderately differentiated,n=2),mucinous adenocarcinoma(moderately differentiated,n=2)and goblet cell adenocarcinoma(moderately differentiated,n=1).Conclusion In clinical practices,AA is extremely rare.Due to a lack of specific symptoms,a preoperative diagnosis is rather difficult.Preoperative CT and colonoscopy may aid a definite diagnosis.Radical operation of right colon is routinely performed.Intraoperative and postoperative intraperitoneal hyperthermic perfusion chemotherapy is feasible for tumors invading serosa.And postoperative chemotherapy should be supplemented according to clinical stages.
作者
韩非
刘俊
Han Fei;Liu Jun(Department of Gastrointestinal Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science&Technology,Hubei Wuhan 430022,China)
出处
《腹部外科》
2023年第3期236-239,共4页
Journal of Abdominal Surgery
关键词
阑尾肿瘤
腺癌
诊断
治疗
右半结肠切除术
Appendiceal tumor
Adenocarcinoma
Diagnosis
Treatment
Right hemicolectomy