Laparoscopy-assisted Partial Cecum Resection Versus Ileocecal Resection for Non-malignant Appendiceal Neoplasms

Area of Science:

• Gastrointestinal Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Preoperative diagnosis of appendiceal tumors is challenging.
• Low-grade appendiceal mucinous neoplasms (LAMN) rarely metastasize but can have positive surgical margins with appendectomy.
• Partial cecum resection is an option for LAMN, but laparoscopic benefits are unclear.

Purpose of the Study:

• To compare the outcomes of laparoscopy-assisted partial cecum resection (Lap-Ce) versus laparoscopy-assisted ileocecum resection (Lap-ICR) for primary appendiceal tumors.
• To evaluate the feasibility and benefits of Lap-Ce in obtaining negative resection margins.
• To assess perioperative outcomes and recurrence rates between the two surgical approaches.

Main Methods:

• Retrospective analysis of patients undergoing Lap-Ce or Lap-ICR for primary appendiceal tumors.
• Intraoperative pathological diagnosis was performed at surgeon's discretion.
• Comparison of clinicopathological factors and surgical outcomes between the Lap-Ce and Lap-ICR groups.

Main Results:

• Higher intraoperative consultation rates in Lap-Ce (86%) vs. Lap-ICR (4%).
• Lap-Ce used fewer trocars (3 vs. 5), had shorter operative times (113 vs. 197 min), and less blood loss (1 vs. 32 ml).
• Lap-Ce patients had quicker return to bowel function (2 vs. 3 days), with no recurrence in either group.

Conclusions:

• Laparoscopy-assisted partial cecum resection is less invasive than laparoscopy-assisted ileocecum resection based on perioperative variables.
• Lap-Ce is a beneficial primary surgical procedure for clinically benign appendiceal lesions.
• The study supports Lap-Ce as an effective minimally invasive approach for managing select appendiceal tumors.