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Related Experiment Videos

Laparoscopic versus open resection for appendix carcinoid.

P Bucher1, P Gervaz, F Ris

  • 1Clinic of Visceral and Transplantation Surgery, Department of Surgery, University Hospital Geneva, 24, Rue Micheli-du-Crest, 1211, Geneva, 14, Switzerland. Pascal.Bucher@hcuge.ch

Surgical Endoscopy
|June 2, 2006
PubMed
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Laparoscopic appendectomy (LAP) is a safe and effective treatment for appendix carcinoid (AC), showing similar oncologic outcomes to open appendectomy (OP). Patients with AC should undergo regular colonoscopic screening due to a high risk of associated colorectal cancers.

Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Minimally Invasive Surgery

Background:

  • Increasing use of laparoscopic appendectomy (LAP) necessitates evaluating its impact on appendix carcinoid (AC) outcomes.
  • Comparing laparoscopic versus open appendectomy (OP) for AC is crucial for patient management.

Purpose of the Study:

  • To compare the oncologic and long-term outcomes of laparoscopic appendectomy (LAP) versus open appendectomy (OP) for appendix carcinoid (AC).
  • To assess if AC is a contraindication for LAP.

Main Methods:

  • Retrospective review of 39 patients treated for AC between 1991-2003.
  • Comparison of outcomes between laparoscopic (LAP) and open (OP) appendectomy groups.
  • Complete follow-up for all patients (median 67 months).

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Main Results:

  • No significant difference in positive surgical margins between LAP and OP groups.
  • Similar rates of right colectomy for AC >2 cm between LAP and OP.
  • Actuarial 5-year survival rates were 100% for LAP and 94% for OP (p=0.2).
  • Six patients (15%) developed synchronous or metachronous colorectal carcinomas.

Conclusions:

  • Laparoscopic appendectomy (LAP) offers safe and comparable oncologic and long-term results to open appendectomy (OP) for appendix carcinoid (AC).
  • Pre- or per-operative suspicion of AC should not preclude LAP.
  • Prognosis of AC depends on malignant potential and associated tumors; high risk of colorectal adenocarcinoma warrants colonoscopic screening for all AC patients.