22 december 2008: Bron: 1: J Gastrointest Surg. 2008 Dec 17.

Kanker (type adenocarcinoom) van de appendix (blinde darm) wordt zelden ontdekt door een colonscopie bij mensen die klachten hebben die lijken te wijzen op darmkanker. Dit blijkt uit een studie bij 121 darmkankerpatienten die in de periode 1993 tot 2007 allemaal waren behandeld voor darmkanker.  Slechts enkele darmkankerpatienten waren door de colonscopie voor verder onderzoek of naar een behandeling voor darmkanker verwezen. Een ontlastingstest en/of bloedtest (IOBT of FOB ) lijkt veel nauwkeuriger, al vermeldt deze studie niet of daarmee ook beginnende kanker van de appendix kan worden ontdekt. 

Adenocarcinoma of the Appendix Is Rarely Detected by Colonoscopy.

Section of Gastroenterology, Wake Forest University Baptist Medical Center, Medical Center Blvd, Winston-Salem, NC, 27157, USA.

INTRODUCTION: Appendiceal tumors represent a subset of colonic neoplasms that frequently defy early diagnosis only to present at advanced stage with peritoneal metastasis. Data on early detection by colonoscopy is limited to case reports or series. The aim of this study is to determine the diagnostic yield of colonoscopy in detecting appendiceal lesions in patients with appendiceal adenocarcinoma and pseudomyxoma peritonei.

METHODS: We reviewed clinicopathologic data on 121 consecutive patients with histologically confirmed appendiceal adenocarcinoma with pseudomyxoma peritonei presenting to our institution for intraperitoneal hyperthermic chemotherapy (IPHC) and cytoreductive surgery between February, 1993 and August, 2007, focusing on the colonoscopy findings.

RESULTS: Preoperative colonoscopic data were available on 64 patients (average age = 51; 52 for IPHC patients). Abnormal findings included seven patients with appendiceal lesions (11%), 12 patients with cecal abnormalities (19%), and 28 patients with polyps (44%). Twenty-three patients (36%) had a normal colonoscopy. Malignancy was documented in two of the 64 (3.1%) patients on preoperative colonoscopy biopsies.

CONCLUSIONS: Appendiceal abnormalities are infrequently seen on colonoscopy and rarely yield a diagnostic biopsy in patients with appendiceal carcinoma. We found that nearly 42% of patients with carcinoma of the appendix have synchronous colonic polyps, a much higher prevalence than would be expected, supporting a role for a perioperative colonoscopy.

PMID: 19089515 [PubMed - as supplied by publisher]

 


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