Incidence rate and histology of appendiceal neoplasms in complicated versus uncomplicated appendicitis: A meta-analysis and systematic review.
Abscess
Appendicitis
Complicated
Neoplasm
Perforation
Phlegmon
Uncomplicated
Journal
Langenbeck's archives of surgery
ISSN: 1435-2451
Titre abrégé: Langenbecks Arch Surg
Pays: Germany
ID NLM: 9808285
Informations de publication
Date de publication:
09 Nov 2023
09 Nov 2023
Historique:
received:
25
06
2023
accepted:
25
10
2023
medline:
10
11
2023
pubmed:
9
11
2023
entrez:
8
11
2023
Statut:
epublish
Résumé
Studies evaluating the rate and histology of appendiceal neoplasms between complicated and uncomplicated appendicitis include a small number of patients. Therefore, we sought a meta-analysis and systematic review comparing the rates and types of appendiceal neoplasm between complicated and uncomplicated appendicitis. We included articles published from the time of inception of the datasets to September 30, 2022. The electronic databases included English publications in Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, and Scopus. A total of 4962 patients with appendicitis enrolled in 4 comparative studies were included. The mean age was 43.55 years (16- 94), and half were male (51%). Based on intra-operative findings, 1394 (38%) had complicated appendicitis, and 3558 (62%) had uncomplicated appendicitis. The overall incidence rate of neoplasm was 1.98%. No significant difference was found in the incidence rate of appendiceal neoplasm between complicated (3.29%) and uncomplicated (1.49%) appendicitis (OR 0.44, 95% CI 0.16- 1.23; p < 0.087; I2 = 54.9%). The most common appendiceal neoplasms were Neuroendocrine Tumors (NET) (49.21%), Nonmucinous Adenocarcinoma (24.24%), Mixed Adeno-Neuroendocrine Tumor (MANEC) (11.40%), Mucinous Adenocarcinoma (4.44%). There was a significant difference between complicated and uncomplicated appendicitis in rates of adenocarcinoma (50% vs. 13%), NET (31% vs. 74%), MANEC (19% vs. 13%) (P < 0.001). While there was no significant difference in the overall neoplasm rate between complicated and uncomplicated appendicitis, the NET rate was significantly higher in uncomplicated appendicitis. In comparison, the Adenocarcinoma rate was considerably higher in Complicated appendicitis. These findings emphasize the importance of evaluating risk factors for neoplasm when considering appendectomy in patients with appendicitis.
Identifiants
pubmed: 37940770
doi: 10.1007/s00423-023-03164-0
pii: 10.1007/s00423-023-03164-0
pmc: PMC10632310
doi:
Types de publication
Meta-Analysis
Systematic Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
432Informations de copyright
© 2023. The Author(s).
Références
Turk J Gastroenterol. 2020 Mar;31(3):257-263
pubmed: 32343238
Surg Endosc. 2022 Nov;36(11):8107-8111
pubmed: 35449477
Int J Colorectal Dis. 2019 Jan;34(1):39-46
pubmed: 30242478
Int J Colorectal Dis. 2020 Jan;35(1):157-163
pubmed: 31811385
Int J Colorectal Dis. 2020 Nov;35(11):2065-2071
pubmed: 32638091
Neurology. 2021 Jul 27;97(4):e357-e368
pubmed: 33947783
Expert Rev Gastroenterol Hepatol. 2021 Feb;15(2):203-210
pubmed: 33022181
Int J Colorectal Dis. 2022 May;37(5):1173-1180
pubmed: 35474547
Oncologist. 2018 Jan;23(1):137
pubmed: 29317549
J Gastrointest Surg. 2015 Apr;19(4):743-50
pubmed: 25560182
Am Surg. 2019 Feb 1;85(2):223-225
pubmed: 30819303
BJS Open. 2022 Jul 7;6(4):
pubmed: 36029031
BMC Med Res Methodol. 2014 Dec 19;14:135
pubmed: 25524443
Surg Endosc. 2021 Jul;35(7):3855-3860
pubmed: 32676725
J Trauma Acute Care Surg. 2017 Apr;82(4):771-775
pubmed: 28099380
Dis Colon Rectum. 2019 Dec;62(12):1425-1438
pubmed: 31725580