超越急性尾炎:在989次连续的紧急尾切除术后,单一机构的经验发现了意想不到的病理发现
Pietro Fransvea1,2, Caterina Puccioni3,4, Gaia Altieri3
1Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Rome, Italy. pietro.fransvea@policlinicogemelli.it.
Langenbeck's archives of surgery
|March 5, 2024
概括
尾瘤比以前认为的更常见,特别是在老年人中. 简单的尾切除术通常是治愈性的,但年龄是AN的重要危险因素.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 病理学 病理学 病理学
背景情况:
- 尾瘤 (ANs) 是罕见的,神经内分泌瘤 (NETs) 和低度尾粘膜瘤 (LAMNs) 是最常见的.
- 大多数ANs通过尾切除成功治疗,但有些病例需要右侧尾切除和手术内化疗.
研究的目的:
- 评估在单一机构接受紧急尾切除术的成年患者中ANs的患病率,组织类型,治疗和结果.
- 为了比较尾瘤 (AN) 病例与急性尾炎 (AA) 病例.
主要方法:
- 在一个大型学术医疗中心治疗急性尾炎 (AA) 的患者的回顾性队列分析.
- 诊断为AA的患者与AA和确诊的尾瘤 (AN) 患者的比较.
主要成果:
- 尾瘤 (AN) 的总发病率为9.3% (99个尾切除术的989名患者中有92名).
- 随着年龄的增长,AN发生率增加,在30岁以下的患者中为3.8%,在40-89岁的患者中为13.0%.
- 在临床表现或手术方法中没有发现显著差异,但复杂尾炎的发病率在AN组较低.
结论:
- 尾瘤 (ANs) 比文献表明的更为普遍,没有特定的临床指标.
- 简单的尾切除术对大多数AN有治愈作用,但年龄较大是显著的危险因素.
- 这些发现挑战了ANs非操作管理的概念.
相关概念视频
Appendicitis-I: Introduction
140
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
140
Appendicitis-II: Diagnostic Studies and Management
80
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
80
Assessment of the Rectum and Anus
215
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
215
Acute Pancreatitis II: Clinical Manifestations and Management
124
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
124
Endoscopic Procedures V: ERCP
227
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
227
Esophageal Perforation-II: Clinical Manifestations and Management
63
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
63


