OHKI Takeshi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Case report
Language English
Peer review Non peer reviewed
Title Laparoscopic appendectomy for appendiceal intussusception assisted by colonoscopy: A case report.
Journal Formal name:International journal of surgery case reports
Abbreviation:Int J Surg Case Rep
ISSN code:22102612/22102612
Domestic / ForeginForegin
Volume, Issue, Page 89,pp.106611
Author and coauthor OHIRA Kei†, OHKI Takeshi, INOUE Yuji, YAMAMOTO Masakazu
Authorship 2nd author
Publication date 2021/12
Summary INTRODUCTION:Appendiceal intussusception sometimes results from appendiceal cancer. Ileocecal resection instead of appendectomy is often chosen as a treatment as it is technically difficult to resect the appendix alone without causing dissemination of appendiceal cells to the abdominal cavity. Herein, we present the first report of a case in which appendiceal intussusception was treated by resection of the appendix alone via simultaneous colonoscopy and laparoscopy.PRESENTATION OF CASE:A 40-year-old man underwent laparoscopic appendectomy for appendiceal intussusception. Since a neoplastic cause could not be completely ruled out, we planned to carry out oncologically safe appendectomy that would not expose the tumor to the abdominal cavity. The resection was performed in the lumen of the cecum rather than in the abdominal cavity to prevent dissemination of appendiceal cells to the peritoneal cavity during surgery. Histopathologic examination revealed chronic inflammation of the appendix but no malignancy. The postoperative course was uneventful.DISCUSSION:Here, we present a case in which laparoscopic resection of the mesoappendix and colonoscopy-assisted resection of the appendix were performed in combination in a patient with appendiceal intussusception. When the possibility of malignancy is low, this maneuver may prevent patients from undergoing ileocecal resection with lymph node dissection as it prevents exposure of the abdominal cavity to the tumor.CONCLUSION:Simultaneous performance of laparoscopy and intraoperative colonoscopy is feasible and, from an oncological viewpoint, may be preferable when the cause of appendiceal intussusception is unknown or malignancy is not suspected.
DOI 10.1016/j.ijscr.2021.106611
PMID 34801781