ABSTRACT
Primary appendiceal adenocarcinoma is rare, with fewer than 300 reported cases. This report reviews 23 cases of appendiceal adenocarcinoma at Butterworth Hospital from 1968 to 1985. Clinical presentation, operative findings, treatment, and length of survival were recorded. Common clinical presentations included acute appendicitis and progressive abdominal distention. This disease was frequently an incidental finding during unrelated elective surgery and was often associated with other primary malignancies. Surgical treatment included appendectomy, right hemicolectomy, and interval hemicolectomy after initial appendectomy. Improved survival was noted in patients who had localized and noninvasive disease. Prognosis was most closely related to tumor grade. No patient who had localized, well-differentiated tumor died from the disease or had evidence of tumor recurrence after surgical treatment. All patients with poorly differentiated tumors died from widespread carcinomatosis. Appendectomy appears to be sufficient treatment for well-differentiated, localized, mucus secreting adenocarcinomas of the appendix.
Subject(s)
Adenocarcinoma/surgery , Appendiceal Neoplasms/surgery , Adenocarcinoma/diagnosis , Adenocarcinoma/mortality , Adult , Aged , Aged, 80 and over , Appendectomy , Appendiceal Neoplasms/diagnosis , Appendiceal Neoplasms/mortality , Appendicitis/diagnosis , Appendicitis/surgery , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prognosis , Retrospective StudiesABSTRACT
This retrospective study was undertaken to determine if the advent of H2 blockers has altered the surgical treatment and outcome of patients with peptic ulcer disease (PUD). The records of patients having surgery for PUD at Butterworth Hospital, Grand Rapids, Michigan, from 1971-73 (Group 1) and 1981-83 (Group 2) were reviewed. Data recorded included patient and disease characteristics, surgical procedures, morbidity, and mortality. There was a significant difference in mean age: 54 years in Group 1 and 60 years in Group 2. Group 2 had a higher incidence of concomitant medical illnesses. Indications for operation were predominantly of an emergent nature in Group 2, with a marked decline in elective surgeries from 75 per cent to 55 per cent. There was a 15 per cent incidence of nonsurgical complications in Group 2, as opposed to 9 per cent in Group 1. This study demonstrates that the use of H2 blockers and changes in patient characteristics have altered the surgical treatment and outcome of patients with PUD.
