右半结肠癌并发急性阑尾炎:附51例报告
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何建军

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Clinical analysis of right colon cancer complicated with acute appendicitis: a report of 51 cases
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    摘要:

    目的:总结右半结肠癌并发急性阑尾炎的诊治经验。
    方法:回顾性分析经手术和病理证实的右半结肠癌并发急性阑尾炎51例临床资料。
    结果:右半结肠癌2 400例中并发急性阑尾炎51例(2.1%)。有内科合并症者39例(76.5%)。术前诊断13例(25.5%),漏诊结肠癌38例(74.5%)。结肠腺癌40例(78.4%),黏液腺癌7例(13.7%),未分化癌4例(7.8%)。Dukes B期2例(3.9%), C期29例(56.9%),D期20例(39.2%)。单纯性阑尾炎28例(54.9%),化脓性阑尾炎11例(21.6%),坏疽性阑尾炎8例(15.7%),蜂窝织炎性阑尾炎4例(7.8%)。3,5年生存率分别为95.2%,40.0%。
    结论:右半结肠癌并发急性阑尾炎发生率低,误诊率高,5年生存率较低,中老年阑尾炎伴有消瘦、贫血及消化道症状、右下腹肿块者,应做相应检查,避免右半结肠癌漏诊。

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    Objective:To summarize our experience in the diagnosis and treatment of right hemicolon carcinoma combined with acute appendicitis.
    Methods:A respective analysis of clinical data of 51 cases of right colon cancer complicated with acute appendicitis and confirmed by surgical operation and pathology was made.
    Results:In 2400 cases of right colon cancer, 51 cases(2.1%) complicated with appendicitis. There were medical complications in 39 cases (76.5%).The diagnosis before operation was made in 13 cases (25.5%),and diagnosis of colon cancer was missed in 38 cases (74.5%).Colon adenocarcinoma was found in 40 cases,mucous adenocarcinoma 7 cases (13.7%),undifferentiated carcinoma 4 cases (7.8%); and Dukes B, C, D stages were in 2 cases (3.9%), 29 cases (56.9%) and 20 cases (39.2%) respectively.The simple appendicitis, suppurative appendicitis, gangrenous appendicitis and phlegnomous appendicitis was found in 28 cases (54.9%),11 cases (21.6%),8 cases (15.7%)and 4 cases (7.8%) respectively.3-5-year survival was 95.2%, 40.0%, respectively.
    Conclusions:Occurrence rate of right colon cancer combined with appendicitis is low, but misdiagnosis rate is high, and 5-year survival rate is low.Middle and old age patients with appendicitis and accompanied with emaciation,anemia,digestive symptoms and right lower abdominal mass should have appropriate examination to avoid missing the diagnosis of right colon cancer.

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许克勤, 何建军.右半结肠癌并发急性阑尾炎:附51例报告[J].中国普通外科杂志,2009,18(4):15-378.
DOI:10.7659/j. issn.1005-6947.2009.04.015

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  • 在线发布日期: 2009-04-25