An Analysis on the Diagnosis and Treatment of 32 Cases of Appendiceal Carcinoid / 中国医师杂志

ABSTRACT

Objective To explore the diagnosis and surgical management experience of appendiceal carcinoid. Methods The clinical data of 32 patients with appendiceal carcinoid from 1978 to 1998 were retrospectively analyzed. Results 26 patients (26/32, 81 25%) manifested the sign and symptom of appendicitis, and 6 patients (6/32, 18 75%) with carcinoid were incidentally discovered. The tumors were less than 1cm in diameter in 25 patients, between 1 and 2 cm in 4 patients, and larger than 2 cm in 3 patients. Tumor invasion was confined to the appendix in 29 patients, involved in the mesoappendix in 2 patients, and one patient had local lymphonodus metastasis. Three carcinoid patients with tumor lymph-nodes metastasis in the mesoappendix underwent secondary right hemicolectomy, 2 patients underwent appendicocecostomy, and 27 patients underwent appendectomy. The follow-up was performed in 28 patients, and all patients remained free of tumor recurrence and metastasis. Conclusion Appendiceal carcinoid was rare, and most of the patients manifested the sign and symptom of appendicitis. Appendiceal carcinoid of less than 1 cm diameter could be adequately managed by appendectomy alone. Appendiceal carcinoid in basis of the appendix could be adequately managed by appendicocecostomy. The treatment approach for tumors of 1 to 2 cm in diameter was still controversial. The right hemicolectomy should be performed in the patients with larger than 2 cm in diameter tumors.