충수 점액낭종의 임상적 고찰 및 복강경 수술의 경험 (Clinical Analysis and Laparoscopic Surgical Experience for an Appendiceal Mucocele)

서지정보

· 발행기관 : 대한내시경로봇외과학회
· 수록지 정보 : Journal of Minimally Invasive Surgery / 12권 / 1호 / 31 ~ 36페이지
· 저자명 : 장은영, 박종훈, 이정안, 조해창, 구미진

초록

Purpose: A mucocele of the appendix is an infrequent entity of appendiceal pathology. A preoperative diagnosis is important to determine for appropriate treatment and to avoid unintended rupture of the mucocele during surgery. The purpose of our study was to identify the clinical features of an appendiceal mucocele (AM) and to describe the experience of the use of the laparoscopic approach for an AM. Methods: Between July 1998 and July 2008, 32 cases of AM were diagnosed. We reviewed the clinicopathological characteristics and surgical experience for an AM. Results: The incidence of an AM was 0.66% for 4825 performed appendectomies. Most cases manifested with symptoms of abdominal pain (84.4%), but two cases were determined based on CT incidental findings. A preoperative diagnosis of a mucocele was determined for 34.4% of the cases. The use of ultrasonography, CT and colonoscopy helped to achieve a correct diagnosis. Open surgery was performed in 15 cases and laparoscopic surgery was performed in 17 cases. For patients that underwent an appendectomy, the mean operation time and diet-start date were significantly shorter for patients that underwent laparoscopic surgery as compared to patients that underwent open surgery (p=0.030, p=0.007, respectively). Pathology identified mucosal hyperplasia (25%), mucinous cystadenoma (59.4%) and a simple mucocele (15.6%). The mean duration of follow-up was 46 months. Recurrence or development of pseudomyxoma peritonei and complications after laparoscopic surgery were not seen. Conclusion: Laparoscopic resection of an AM was feasible when there was no mucinous spillage. Close follow-up is recommended in all patients due to the risk of recurrence in the form of pseudomyxoma peritonei or a gastrointestinal neoplasm.

영어초록

Purpose: A mucocele of the appendix is an infrequent entity of appendiceal pathology. A preoperative diagnosis is important to determine for appropriate treatment and to avoid unintended rupture of the mucocele during surgery. The purpose of our study was to identify the clinical features of an appendiceal mucocele (AM) and to describe the experience of the use of the laparoscopic approach for an AM. Methods: Between July 1998 and July 2008, 32 cases of AM were diagnosed. We reviewed the clinicopathological characteristics and surgical experience for an AM. Results: The incidence of an AM was 0.66% for 4825 performed appendectomies. Most cases manifested with symptoms of abdominal pain (84.4%), but two cases were determined based on CT incidental findings. A preoperative diagnosis of a mucocele was determined for 34.4% of the cases. The use of ultrasonography, CT and colonoscopy helped to achieve a correct diagnosis. Open surgery was performed in 15 cases and laparoscopic surgery was performed in 17 cases. For patients that underwent an appendectomy, the mean operation time and diet-start date were significantly shorter for patients that underwent laparoscopic surgery as compared to patients that underwent open surgery (p=0.030, p=0.007, respectively). Pathology identified mucosal hyperplasia (25%), mucinous cystadenoma (59.4%) and a simple mucocele (15.6%). The mean duration of follow-up was 46 months. Recurrence or development of pseudomyxoma peritonei and complications after laparoscopic surgery were not seen. Conclusion: Laparoscopic resection of an AM was feasible when there was no mucinous spillage. Close follow-up is recommended in all patients due to the risk of recurrence in the form of pseudomyxoma peritonei or a gastrointestinal neoplasm.

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