CAJ | 학술논문

目的探讨阑尾腺癌的临床特点.方法回顾性分析沈阳市第四人民医院普通外科2005年9月至2010年12月收治的5例阑尾腺癌患者的临床资料.结果 5例患者均为阑尾腺癌,其中2例术中高度怀疑为阑尾恶性肿瘤,送冰冻病理学检查证实为阑尾腺癌,一期行右半结肠切除术；1例行单纯阑尾切除术,术后病理学检查证实为阑尾腺癌,2周后二期行右半结肠切除术；1例术前诊断为阑尾周围脓肿,术中无法单纯切除阑尾,行右半结肠切除术,术后病理学检查证实为阑尾腺癌；1例术前诊断为下腹部占位性病变,腹腔广泛转移,术中证实为阑尾肿瘤,伴腹腔转移,行右半结肠切除、腹腔转移癌切除术.5例术后均辅以化疗.术后随访2～3年,4例无转移,1例术前诊断为下腹部占位性病变、广泛腹腔转移的患者,术后2年再次出现转移.结论阑尾腺癌误诊率高,术中仔细探查及冰冻病理学检查有助于确诊,确诊后应行右半结肠切除术.
목적 탐토란미선암적림상특점.방법 회고성분석침양시제사인민의원보통외과2005년9월지2010년12월수치적5례란미선암환자적림상자료.결과 5례환자균위란미선암,기중2례술중고도부의위란미악성종류,송빙동병이학검사증실위란미선암,일기행우반결장절제술；1례행단순란미절제술,술후병이학검사증실위란미선암,2주후이기행우반결장절제술；1례술전진단위란미주위농종,술중무법단순절제란미,행우반결장절제술,술후병이학검사증실위란미선암；1례술전진단위하복부점위성병변,복강엄범전이,술중증실위란미종류,반복강전이,행우반결장절제、복강전이암절제술.5례술후균보이화료.술후수방2～3년,4례무전이,1례술전진단위하복부점위성병변、엄범복강전이적환자,술후2년재차출현전이.결론 란미선암오진솔고,술중자세탐사급빙동병이학검사유조우학진,학진후응행우반결장절제술.
Objective To evaluate the clinical features of adenocarcinoma of the appendix.Methods The clinical data of 5 patients with adenocarcinoma of appendix hospitalized at our hospital from Sep 2005 to Dec 2010 were analyzed.Results Intraoperatively two cases were highly suspected of malignant tumor of the appendix,diagnosis of adenocarcinoma was confirmed by frozen pathology,and one stage right hemicolectomy was performed.One patient received simple appendectomy,but postoperative pathology showed adenocarcinoma of appendix and secondary right hemicolectomy was carried out two weeks later.One patient was preoperatively misdiagnosed as periappendiceal abscess and as a result fight hemicolectomy was performed because planned appendectomy was technically impossible.The postoperative pathology revealed adenocarcinoma of the appendix.In the last patient preoperative diagnosis was hypogastric space-occupying lesion with extensive intraabdominal metastasis.During exploration adenocarcinoma of the appendix with extensive metastasis was confirmed.Right hemicolectomy and carcinectomy was performed.Postoperatively all the 5 patients underwent regular chemotherapy.We followed them for 2 to 3 years and only the patient with intraabdominal metastasis at first laparotomy suffered from extensive recurrence 2 years after surgery.Conclusions The adenocarcinoma of appendix can be easily misdiagnosed as other diseases.Radiography,careful exploration during operation and frozen pathology help establish final diagnosis.Right hemicolectomy and postoperative chemotherapy are required in order to reduce tumor recurrence and prolong patients' survival.