Radical appendectomy as an alternative to right colon resection in patients with epithelial appendiceal neoplasms.
OBJECTIVE
Appendectomy is an extremely common surgical procedure usually performed for an inflammatory process within this organ. Upon occasion, the pathology within the appendix is a neoplastic process which requires definitive oncologic management.


METHODS
The optimal management strategies for appendiceal neoplasms were reviewed and pertinent literature critically evaluated. The technology for appendectomy for an inflammatory process and an appendectomy for a neoplastic process were compared and contrasted.


RESULTS
A new surgical procedure called "radical appendectomy" was described and its merits for optimizing the management of an appendiceal neoplasm enumerated. The technology of radical appendectomy was described. The possible shortcomings that may be encountered in performing a new surgical methodology for appendectomy was presented and the results of a technically perfect radical appendectomy enumerated. The integration of a radical appendectomy with perioperative hyperthermic chemotherapy was described.


CONCLUSIONS
When a malignancy exists as the cause of appendiceal pathology, the radical appendectomy will provide the maximal amount of information required for optimal decisions regarding patient management.
Surgical Oncology, MD Anderson Cancer Center, Madrid, Spain.
Santiago
S
González-Moreno
Program in Peritoneal Surface Oncology, Center for Gastrointestinal Malignancy, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address: Paul.Sugarbaker@medstar.net.
Paul H
PH
Sugarbaker
D002288:Adenocarcinoma, Mucinous / Q000601:surgery*; D001062:Appendectomy / Q000379:methods*; D001063:Appendiceal Neoplasms / Q000601:surgery*; D003106:Colon / Q000601:surgery*; D006801:Humans; D010534:Peritoneal Neoplasms / Q000601:surgery*; D017410:Practice Guidelines as Topic / Q000592:standards*; D011379:Prognosis
Cytoreductive surgery; Disseminated peritoneal adenomucinosis (DPAM); Early postoperative intraperitoneal chemotherapy (EPIC); Hyperthermic intraperitoneal chemotherapy (HIPEC); Low-grade mucinous appendiceal neoplasms (LAMN); Mucinous adenocarcinoma of the appendix (MACA); Mucinous appendiceal neoplasms (MAN); Peritoneal mucinous carcinoma (PMCA); Sentinel lymph node