B. Ricci

C. Sticchi

E. Gianetta

E. Picori

F. Mandolfino

G.C.Larghero

L. De Salvo

M. Frascio

R. Fornaro

FORNARO, ROSARIO

FRASCIO, MARCO

G. C. Larghero

DE SALVO, LUIGI

GIANETTA, EZIO

Archivio istituzionale della ricerca - Università di Genova

 Roma 15-18 ottobre 2006 Categoria: CHIRURGIA ENDOCRINA  Argomento: I tumori endocrini dell’apparato digerente Autori: FORNARO R. (GE) , FRASCIO M. (GE) , PICORI E. (GE) , STICCHI C. (GE) , RICCI B. (GE) , MANDOLFINO F. (GE) , LARGHERO G. (GE) , DE SALVO L. (GE) , GIANETTA E. (GE)  Istituzione: UNIVERSITÀ DI GENOVA - DIPARTIMENTO DI CHIRURGIA - PATOLOGIA CHIRURGICA A INDIRIZZO GASTROENTEROLOGICO  Relatore: FORNARO R. GE E-Mail Relatore: rfornaro@unige.it  Titolo Comunicazione: APPENDICEAL CARCINOID TUMORS : APPENDECTOMY OR RIGHT HEMICOLECTOMY  Introduzione: Carcinoids of the appendix continue to be of interest, despite their low incidence. Controversy still exist, especially whit regard to the role of right hemicolectomy in pts with tumors less < 2 cm. The aim was to underline the current therapeutic knowledge and to propose criteria for the indications of appendectomy or hemicolectomy in the surgical treatment of appendiceal carcinoids.  Metodo: The records of the pts who underwent appendectomies from 1990 to 2000 were analyzed. Seven patients were included in the study. The clinical data were reviewed for the demographic details, tumor size, localization in the appendix, histological patterns and surgical procedure. Six pts underwent an appendicectomy (including removal of the mesenteriolum in all cases), in one a right hemicolectomy was performed. The mean follow-up was 7 years (range 4-14). The data included symptomps, 5-hydroxy-indole-acetic acid and ultrasound examination, computerized tomography scanning, octreoscan.  Risultati: Seven pts (0.9% of all appendectomies) were reported to have carcinoid tumors of the appendix. They were 43% male and 57% female. The middle age was 29 years. All pts were admitted due to appendicitis. None had carcinoid syndrome. The site of the tumor was the apex of the appendix (57%), the body (29%) and the base (14%), while in 1 pts the mesoappendix was invaded. The mean diameter was of 8 mm (range 5-29 mm); in 6 pts was < 2 cm. The treatment was appendectomy in 6 cases (86%); the right hemicolectomy was necessary in 1 case (14%) because a tumor > 2 cm. The 7-year survival rate is 100%. Six pts are without disease, while 1 pts developed metastases in the liver 6 years after operation.  Conclusioni: It is possible identify criteria that orient toward a major surgery (hemicolectomy) or minor surgery (appendectomy). Reasons for more extensive surgery than appendicectomy are : size of the tumor > 2 cm, lymphatic invasion, involvement of the lymph nodes, location at the base, diffusion to the meso-appendix, tumor-positive margins, cellular pleiomorfism with a high mitotic index.  

English

Appendiceal carcinoid tumors: appendectomy or right hemicolectomy.

Appendiceal carcinoid tumors: appendectomy or right hemicolectomy.

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Archivio istituzionale della ricerca - Università di Genova