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Primary Surgical Therapy

Added 06 March 2013

  • Standard appendectomy is adequate for simple cystadenomas.
  • Patients found unexpectedly at the time of laparotomy or laparoscopy to have a mucinous appendiceal tumour should simply have an appendectomy. More extensive surgery (right hemicolectomy, omentectomy etc) increases the technical difficulty of the subsequent definitive operation without any acute benefit to the patient.
    • Right hemicolectomy is indicated for:
    • complicated cystadenomas with involvement of the terminal ileum or cecum
    • goblet cell carcinomas - especially those that are greater than 2 cm, involve the base of the appendix, associated with nodal metastases, or have atypical histology.
  • any appendiceal adenocarcinoma or cystadenocarcinoma.
  • Surgical debulking is the recommended approach for symptomatic DPAM
  • Aggressive cytoreductive surgery with intraperitoneal chemotherapy may be considered in selected patients with intraperitoneal disease at specialized surgical centres. Referral to the BCCA for multidisciplinary assessment is recommended.

SOURCE: Primary Surgical Therapy ( )
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