Diagnosis and surgical treatment of carcinoid tumors of the appendix in 64 patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To summarize the experience in the diagnosis and surgical treatment of carcinoid tumors of the appendix.</p><p><b>METHODS</b>From 1972 to 2006, 64 patients with carcinoid tumors of the appendix received surgical treatment in our hospitals. The clinical data of those patients were retrospectively analyzed.</p><p><b>RESULTS</b>Of the 64 cases, only 6 cases (9.4%) were correctly diagnosed preoperatively, while 58 (90.6%) not confirmed, with a misdiagnosis rate of 90.6%. All patients underwent surgical treatment, including appendectomy in 54, ileocecectomy in 4, right hemicolectomy in 2 and right hemicolectomy with regional lymph node dissection in 4 cases. The operation modes were determined according to the doctor's judgments based on the age of the patients, the nature, size, location, infiltration depth and lymph node metastasis of the tumors. Of the 64 patients, 58 were followed up with a longest follow-up period of 13 years, while 6 lost follow-up. Fifty-seven of those were still surviving, only one died of liver metastasis at 13 years after operation.</p><p><b>CONCLUSION</b>Carcinoid tumor of the appendix is rare with a high rate of misdiagnosis before operation. Surgical resection is the only effective treatment for this disease and proper operation mode is the key to achieve good survival.</p>

Intractable constipation caused by adult dolichocolon / 中国普通外科杂志

Objective To summarize the diagnosis and surgical treatment for intractable constipation caused by adult dolichocolon.Methods Clinical data of 82 adult dolichocolon cases suffering from intractable constipation were analyzed retrospectively.Results Of the 82 patients,intractable constipation were found in 66 patients(80%),abdominalgia,abdominal distension in 28 patients(34%) and constipation alternatively with diarrhea in 16 patients(19%).Diagnosis was established in 74 patients by barium enema while 8 during the emergency operation.Dolichocolon was divided into 3 types as type Ⅰ in 35 cases,type Ⅱ in 19 and type Ⅲ in 28,in which there were 18 cases of total dolichocolon syndrome. Surgery performed including sigmoidectomy(32 patients),right hemicolectomy(3 patients),right hemicolon and transvers colon resection(4 patients),left side of transvers colon and splenic flexure colon resection(4 patients),descending colon and sigmoid colon resection(15 patients),transvers,descending and sigmoid colon resection(6 patients),pancolectomy with anastomosis of terminal ileum and upper rectum (18 patients).There were no severe postoperative complications such as anastomotic leakage and the recovery was uneventful in all 82 patients.The curative effect was graded as well and up in all 72 cases followed up from 3 months to 4 years,with a follow-up rate of 88%(72/82).Conclusion A history of intractable constipation and barium enema are the mainstay for the diagnosis of dolichocolon,and operation is the effective treatment for intractable constipation caused by adult dolichocolon.