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目的 通过11 例阑尾肿物的临床追踪分析,探讨其诊断和外科治疗的疗效。方法 回顾性研究1980~1999 年接受治疗的经病理证实的阑尾肿物,根据其临床表现和辅助检查的特点,结合文献讨论有关诊治问题。结果 粘液囊肿4 例,类癌4 例,腺癌1 例,腺癌部分癌变1 例,平滑肌肉瘤1 例。术前仅1 例粘液囊肿获正确诊断。本组11 例均行手术治疗,根据术中冰冻病理结果,类癌肿块直径> 1cm 者行右半结肠切除术,腺癌者行右半结肠切除加区域淋巴结清扫术,平滑肌肉瘤者行阑尾加盲肠部分切除,余7 例仅行阑尾切除术。除3 例死于非相关因素外,其余均获得良好疗效。结论 术中仔细探查和冰冻病理对正确的手术方式选择有重要作用。
Objective To investigate the clinical efficacy of the diagnosis and surgical treatment of 11 cases of appendix tumors. Methods Retrospectively studied the pathologically confirmed appendix masses that were treated from 1980 to 1999. According to the characteristics of their clinical manifestations and auxiliary examinations, combined with the literature to discuss the diagnosis and treatment issues. Results There were 4 cases of mucocyst, 4 cases of carcinoid, 1 case of adenocarcinoma, 1 case of adenocarcinoma, 1 case of leiomyosarcoma. Only 1 case of mucinous cyst was correctly diagnosed before surgery. All 11 cases in this group were treated with surgery. According to the frozen pathological results during operation, right hemicolectomy was performed for tumors with tumor diameter>1cm, right hemicolectomy plus regional lymph node dissection for adenocarcinoma, and iliac muscle for leiomyosarcoma. The cecum was partially removed and the remaining 7 patients underwent appendectomy. Except for 3 cases that died of non-related factors, the rest achieved good results. Conclusion Careful exploration and frozen pathology play an important role in the correct choice of surgical procedure.