Radical appendectomy as an alternative to right colon resection in patients with epithelial appendiceal neoplasms

Surg Oncol. 2017 Mar;26(1):86-90. doi: 10.1016/j.suronc.2017.01.006. Epub 2017 Feb 1.

Abstract

Objective: Appendectomy is an extremely common surgical procedure usually performed for an inflammatory process within this organ. Upon occasion, the pathology within the appendix is a neoplastic process which requires definitive oncologic management.

Methods: The optimal management strategies for appendiceal neoplasms were reviewed and pertinent literature critically evaluated. The technology for appendectomy for an inflammatory process and an appendectomy for a neoplastic process were compared and contrasted.

Results: A new surgical procedure called "radical appendectomy" was described and its merits for optimizing the management of an appendiceal neoplasm enumerated. The technology of radical appendectomy was described. The possible shortcomings that may be encountered in performing a new surgical methodology for appendectomy was presented and the results of a technically perfect radical appendectomy enumerated. The integration of a radical appendectomy with perioperative hyperthermic chemotherapy was described.

Conclusions: When a malignancy exists as the cause of appendiceal pathology, the radical appendectomy will provide the maximal amount of information required for optimal decisions regarding patient management.

Keywords: Cytoreductive surgery; Disseminated peritoneal adenomucinosis (DPAM); Early postoperative intraperitoneal chemotherapy (EPIC); Hyperthermic intraperitoneal chemotherapy (HIPEC); Low-grade mucinous appendiceal neoplasms (LAMN); Mucinous adenocarcinoma of the appendix (MACA); Mucinous appendiceal neoplasms (MAN); Peritoneal mucinous carcinoma (PMCA); Sentinel lymph node.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma, Mucinous / surgery*
  • Appendectomy / methods*
  • Appendiceal Neoplasms / surgery*
  • Colon / surgery*
  • Humans
  • Peritoneal Neoplasms / surgery*
  • Practice Guidelines as Topic / standards*
  • Prognosis