How to Treat an Appendiceal Inflammatory Mass: Operatively or Nonoperatively?

Deelder, J. D.; Richir, Milan C.; Schoorl, T.; Schreurs, W. H.

doi:10.1007/s11605-014-2460-1

Cited by 62 publications

(77 citation statements)

References 14 publications

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“…It must be mentioned that this meta-analysis was subject to large heterogeneity [100]. Recent cohort studies draw opposite conclusions [101, 102]. They opt for a more aggressive surgical approach at time of presentation in case of an appendicular mass or appendicular abscess, based upon the idea that there is a relative high failure rate for non-surgical treatment [101, 102].…”

Section: Pre-operative Carementioning

confidence: 99%

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

et al. 2016

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Unequivocal international guidelines regarding the diagnosis and management of patients with acute appendicitis are lacking. The aim of the consensus meeting 2015 of the EAES was to generate a European guideline based on best available evidence and expert opinions of a panel of EAES members. After a systematic review of the literature by an international group of surgical research fellows, an expert panel with extensive clinical experience in the management of appendicitis discussed statements and recommendations. Statements and recommendations with more than 70 % agreement by the experts were selected for a web survey and the consensus meeting of the EAES in Bucharest in June 2015. EAES members and attendees at the EAES meeting in Bucharest could vote on these statements and recommendations. In the case of more than 70 % agreement, the statement or recommendation was defined as supported by the scientific community. Results from both the web survey and the consensus meeting in Bucharest are presented as percentages. In total, 46 statements and recommendations were selected for the web survey and consensus meeting. More than 232 members and attendees voted on them. In 41 of 46 statements and recommendations, more than 70 % agreement was reached. All 46 statements and recommendations are presented in this paper. They comprise topics regarding the diagnostic work-up, treatment indications, procedural aspects and post-operative care. The consensus meeting produced 46 statements and recommendations on the diagnostic work-up and management of appendicitis. The majority of the EAES members supported these statements. These consensus proceedings provide additional guidance to surgeons and surgical residents providing care to patients with appendicitis. Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-016-5245-7) contains supplementary material, which is available to authorized users.

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Section: Pre-operative Carementioning

confidence: 99%

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

et al. 2016

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“…It’s reported that 2 to 6% of acute appendicitis cases consist in inflammatory appendiceal mass [8], and recent series demonstrate an elevated incidence of malignant tumors in this organ, between 5.9 and 12% [9, 10]. …”

Section: Introductionmentioning

confidence: 99%

Acute appendicitis, inflammatory appendiceal mass and the risk of a hidden malignant tumor: a systematic review of the literature

et al. 2017

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IntroductionAcute appendicitis is significantly common. Despite the increased use of computed tomography, the number of perforated cases has been stable in the past three decades. Between 2% and 6% of patients with acute appendicitis present appendiceal mass, often described as inflammatory phlegmon or abscess. Malignant tumors are confirmed by pathological analysis in 0.9–1.4% of all appendectomies performed to treat acute appendicitis. However, recent series demonstrate an elevated incidence of malignancies, ranging from 5.9 to 12%, in patients with inflammatory appendiceal mass.MethodsThe analysis was based on a systematic review of the literature. The articles were searched in PubMed for the period from 1987 to 2016. Articles presenting the incidence of the hidden malignancy among patients with appendiceal inflammatory mass were selected. Variables as age, interval appendectomy rate, the incidence of neoplasm, time to surgery, minimally invasive assessment, histology, right colectomy rate and morbidity were analyzed.ResultsA total of 13.244 patients were described as presenting acute appendicitis. Appendiceal tumor is present in approximately 1% of the appendectomies, while the rate of neoplasm varies from 10 to 29% in patients presenting appendiceal inflammatory mass. Interval appendectomies, despite been the minority of the procedures, disregard the higher morbidity associated with right sided colectomies. The review of literature also describes oncologic, histologic and clinical aspects of patients presenting appendiceal neoplasm, describing the most frequent histologic subtypes of this illness.ConclusionHidden appendiceal neoplasm in acute appendicitis are rare, fortunately. However, its incidence is much higher in patients presenting appendiceal inflammatory mass. Hence, interval appendectomy should be considered in this subgroup of patients.

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“…Studies have reported that appendiceal tumor detection rates in patients with a periappendicular mass up to 6.0-12.0%. 9,15 In our study, 45 (0.9%) of the appendectomy patients were found to have an appendiceal inflammatory mass (plastron appendicitis). Interval appendectomy was performed in these patients who were treated conservatively, 6-8 weeks later.…”

Section: Introductionmentioning

confidence: 52%

Apendiks Tümörlerinin İnsidansı, Tedavisi ve Sağ Kalım: Retrospektif Bir Çalışma

Kocaöz

Gemcioğlu

Yilmaz

et al. 2019

Online Türk Sağlık Bilimleri Dergisi

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ÖzBu araştırma, appendektomi sırasında alınan numunelerden elde edilen sonuçlara göre tümörlerin klinik ve patolojik özelliklerini ve insidanslarını belirlemek, tanılama sonrasında yapılan tedavileri ve hastaların sağ kalım sürelerini değerlendirmek amacıyla yapılmıştır. Retrospektif olarak yapılan bu araştırmanın verileri, 2007-2017 yılları arasında Ankara Atatürk Eğitim ve Araştırma Hastanesi'nde akut apandisit ön tanısıyla opere edilen 4813 hastanın dosyasından elde edilmiştir. Appendektomi yapılan hastaların 15 (%0,31)'inde appendiks tümörü olduğu saptanmıştır. Bu hastaların tümörlerinin histopatolojik sınıflandırmaya göre 8'inde karsinoid tümör, 6'sında müsinöz adenokarsinom ve 1'inde adenokarsinom olduğu belirlenmiştir. Karsinoid tümörlü hastaların yaş ortalaması 30,29±7,95, müsinöz adenokarsinomlu hastaların yaş ortalaması 65±18,81 olarak saptandı. Kadınlarda erkeklere göre iki kat daha fazla appendiks tümörünün geliştiği tespit edilmiştir. Tümör çapı 1 cm'den küçük olan 9 hastaya sadece appendektomi operasyonu yapılmış ve takipleri sonrasında tümörlerin nüks etmediği belirlenmiştir. Postoperatif mezoappendiks tutulumu olan 3 hastaya, ikinci operasyonda sağ hemikolektomi yapılmıştır. Ameliyat öncesi çekilen bilgisayarlı tomografide, 3 hastada periapendiküler kitle tespit edildi. Maligniteden şüphelenilen bu üç hastaya sağ hemikolektominin yanı sıra omentektomi, peritonektomi ve lenf nodu diseksiyonu operasyonu gerçekleştirilmiştir. Hastaların beş yıllık yaşam süresi kasinoid tümörü olanlarda %100 iken, müsinöz adeno karsinomlarda %67 olduğu saptanmıştır. Sonuç olarak, araştırmamızda kadınlarda erkeklere göre daha fazla görüldüğü saptanan appendiks tümörlerinin çoğunluğu rastlantısal olarak tespit edilmiştir. Karsinoid tümörlü olan hastaların prognozu ve hayatta kalım oranları, müsinöz adeno karsinomlulara göre daha iyi olduğu belirlenmiştir. Bu nedenle appendiks tümörün histopatolojik incelemesi sonrasında elde edilen rapora göre hastaların takibinin ve tedavisinin yapılması önemlidir. AbstractThis study was made to determine the clinical and pathological features and incidences of tumors according to the results obtained from the samples taken during an appendectomy, to evaluate the post-diagnosis treatments and the survival time of patients. The data of this retrospective study had from the files of 4813 patients who were operated with pre-diagnosis of acute appendicitis at Ankara Atatürk Training and Research Hospital between 2007-2017. Fifteen (0.31%) of the patients who underwent appendectomy were detected to have appendix tumors. According to the histopathological classification of tumors of these patients, it was determined that 8 of them had a carcinoid tumor, 6 of them had mucinous adenocarcinoma and 1 of them had adenocarcinoma. The mean age of the patients with carcinoid tumor was 30.29 ± 7.95 and the mean age of the patients with mucinous adenocarcinoma was 65 ± 18.81. It has been determined that women develop two times more appendix tumors than men. Nine patients with a tumor diameter less tha...

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How to Treat an Appendiceal Inflammatory Mass: Operatively or Nonoperatively?

Cited by 62 publications

References 14 publications

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

Acute appendicitis, inflammatory appendiceal mass and the risk of a hidden malignant tumor: a systematic review of the literature

Apendiks Tümörlerinin İnsidansı, Tedavisi ve Sağ Kalım: Retrospektif Bir Çalışma

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