Case Report
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World J Gastrointest Surg. May 27, 2014; 6(5): 84-87
Published online May 27, 2014. doi: 10.4240/wjgs.v6.i5.84
Single-incision laparoscopic cecectomy for low-grade appendiceal mucinous neoplasm after laparoscopic rectectomy
Shiki Fujino, Norikatsu Miyoshi, Shingo Noura, Tatsushi Shingai, Yasuhiko Tomita, Masayuki Ohue, Masahiko Yano
Shiki Fujino, Norikatsu Miyoshi, Shingo Noura, Masayuki Ohue, Masahiko Yano, Departments of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka-city, 558-8585 Osaka, Japan
Tatsushi Shingai, Departments of Surgery, Saiseikai Senri Hospital, Suita-city, 590-0072 Osaka, Japan
Yasuhiko Tomita, Departments of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-Ku, Osaka-city, 558-8585 Osaka, Japan
Author contributions: Fujino S and Miyoshi N designed the report; Fujino S, Miyoshi N, Noura S, Shingai T and Ohue M were attending doctors for the patient; Tomita Y performed pathological examinations; Miyoshi N, Ohue M and Yano M organized the report; and Fujino S wrote paper.
Correspondence to: Norikatsu Miyoshi, MD, PhD, Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-Ku, Osaka-city, 558-8585 Osaka, Japan. miyosi-no@mc.pref.osaka.jp
Telephone: +81-6-60721181 Fax: +81-6-69818055
Received: November 21, 2013
Revised: February 12, 2014
Accepted: April 17, 2014
Published online: May 27, 2014
Abstract

In this case report, we discuss single-incision laparoscopic cecectomy for low-grade appendiceal neoplasm after laparoscopic anterior resection for rectal cancer. The optimal surgical therapy for low-grade appendiceal neoplasm is controversial; currently, the options include appendectomy, cecectomy, right hemicolectomy, and open or laparoscopic surgery. Due to the risk of pseudomyxoma peritonei, complete resection without rupture is necessary. We have encountered 5 cases of low-grade appendiceal neoplasm and all 5 patients had no lymph node metastasis. We chose the appendectomy or cecectomy without lymph node dissection if preoperative imaging studies did not suspect malignancy. In the present case, we performed cecectomy without lymph node dissection by single-incision laparoscopic surgery (SILS), which is reported to be a reduced port surgery associated with decreased invasiveness and patient stress compared with conventional laparoscopic surgery. We are confident that SILS is a feasible alternative to traditional surgical procedures for borderline tumors, such as low-grade appendiceal neoplasms.

Keywords: Single-incision laparoscopic surgery, Low-grade appendiceal mucinous neoplasm, Mucocele, Reduced port surgery

Core tip: The optimal surgical therapy for low-grade appendiceal neoplasm is controversial. Due to the risk of pseudomyxoma peritonei, complete resection without rupture is necessary. We performed single-incision laparoscopic surgery (SILS), which is reported to be a reduced port surgery associated with decreased invasiveness and patient stress compared with conventional laparoscopic surgery. We are confident that SILS is a feasible alternative to traditional surgical procedures for borderline tumors, such as low-grade appendiceal neoplasms.