Author(s): Vandevelde A, Gera P
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Abstract AIM: The diagnosis of carcinoid tumour is a relatively rare one. Our surgical approach has changed over the last two decades from predominantly open to predominately laparoscopic with a tendency to leave the mesoappendix in situ. The aim of this audit was to identify how many cases we had at PMH and to see whether the shift in surgical approach allowed us to make prognostic decisions in keeping with current best practice and whether this made any difference in further surgery requirements or outcome for patients. METHODS: A retrospective review of all cases of carcinoid identified in our search of all appendicectomy histopathology results was conducted. Results were compared to those found in other studies. Duration of follow up and further investigations was reviewed, as was whether or not there was any recurrence. RESULTS: Our incidence of carcinoid tumours in patients undergoing appendicectomy since 1995 was 0.35\%, similar to that in other centres. None of our patients had surgery beyond an appendicectomy and our active follow up varied from none to 6 months. There were no recurrences in this time. CONCLUSIONS: The literature review carried out suggests further meta-analysis is needed including data on long term follow up before definitive guidelines regarding extent of surgical treatment and follow up based on histopathology are created. The condition is rare and the studies small, resulting in no clear consensus on the best practice for tumours measuring between 1 and 1.5 cm in diameter. Our surgical approach to appendicectomies has changed; it is unclear whether this has resulted in a change in outcome. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.
This article was published in J Pediatr Surg
and referenced in Journal of Clinical Oncology and Practice