Servet KOCAÖZ, Emin GEMCIOĞLU, Abdurrezzak YILMAZ, Aydan KILIÇARSLAN, Ömer PARLAK

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

Bu 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.

Anahtar Kelimeler:

Appendiks tümörü, insidans, histopatoloji, karsinoid tümör, müsinöz adenokarsinom, sağ kalım

Incidence, Treatment and Survival of Appendiceal Tumors: A Retrospective Study

This 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 than 1 cm had only appendectomy operation and it was determined that tumors did not recurrence after the follow-up. Three patients with postoperative mesoappendix involvement underwent right hemicolectomy in the second operation. Preoperative computed tomography revealed periappendicular mass in 3 patients. In addition to right hemicolectomy, omentectomy, peritonectomy and lymph node dissection were performed in these three patients with suspected malignancy. The five-year survival of patients was found to be 100.0% in patients with carcinoid tumors and 67.0% in patients with mucinous adenocarcinomas. In conclusion, the majority of appendiceal tumors in our study that were found to be more widespread in women than in men were detected incidentally. The prognosis and survival rates of patients with carcinoid tumors were better than mucinous adenocarcinomas. Therefore, to made follow-up and treatment of the patients according to the report obtained after histopathologic examination of the appendix tumor is important.

Keywords:

Appendix tumor, incidence, histopathology, carcinoid tumor, mucinous adenocarcinoma, survival,

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