Download PDF
CC BY-NC-ND 4.0 · Journal of Coloproctology 2023; 43(04): e256-e260
DOI: 10.1055/s-0043-1776904
Original Article

Laparoscopic Cecectomy for Diseases of the Appendix and Cecum

Muharrem Oner 
1   Department of Surgery, Al-Zahra Hospital, United Arab Emirates
,
Maher A. Abbas
1   Department of Surgery, Al-Zahra Hospital, United Arab Emirates
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Introduction The cecum is the first part of the large bowel. Cecectomy is a sufficient treatment for some patients, avoiding overtreatment by ileocolic resection.

Purpose The goal of this study was to review a surgeon's experience with laparoscopic cecectomy and provide a technical video demonstration of this uncommon operation.

Methods A retrospective chart review was conducted of all consecutive patients treated with laparoscopic cecectomy over a 16-year period. All operations were performed using a 3-trocar technique. The cecum was transected with 1 to 2 firings of a 60 millimeters linear stapler, preserving the ileocecal valve and ascending colon.

Results 19 patients were identified including 12 females (63.2%). Median age was 42 years (range 16-84). Indication for surgery included appendiceal pathology in 12 patients (63.2%) and cecal abnormality in 7 (38.9%). There was no conversion to open surgery. Median intraoperative blood loss was 25 ml (range 0-150 ml) and no patient received a blood transfusion. No intraoperative or postoperative complication was noted. The median length stay was 1 day (range 0-6). Readmission rate was 0%. Final appendiceal histopathology revealed acute/chronic appendicitis in 5 patients, mucinous cystadenoma in 4 patients. Cecal histopathology revealed adenoma in 4 patients. Median follow-up was 16 months (range 4-53).

Conclusions Laparoscopic cecectomy is a sufficient treatment for some patients with benign conditions of the appendix and cecum. It carries minimal morbidity. It should be considered as an alternative to segmental bowel resection in a select group of patients.

Keywords

cecum - cecectomy - appendicitis - appendiceal tumors - cecal diverticulum - cecal polyp


Publication History

Received: 03 June 2023

Accepted: 24 October 2023

Article published online:
27 November 2023

© 2023. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Lim KH. Duplication of the vermiform appendix in an adult patient. Ann R Coll Surg Engl 2014; 96 (05) e16-e17
    CrossrefPubMedGoogle Scholar
  • 2 Karaffa I, Barra Z, Balog T, Farkas Z, Bezsilla J. [Laparoscopic cecal wedge resection]. Magy Seb 2017; 70 (04) 307-312
    PubMedGoogle Scholar
  • 3 Giavarini L, Boni L, Cortellezzi CC. et al. Laparoscopic caecal wedge resection with intraoperative endoscopic assistance. Int J Surg 2013; 11 (1, Suppl 1) S58-S60
    CrossrefPubMedGoogle Scholar
  • 4 Floyd TL, Orkin BA, Kowal-Vern A. Cecal wedge resection appendectomy for the management of appendiceal polyps. Tech Coloproctol 2016; 20 (11) 781-784
    CrossrefPubMedGoogle Scholar
  • 5 Cakar E, Bayrak S, Bektaş H. et al; -. Carcinoid tumor of the cecum presenting with acute appendicitis: a case report. Chirurgia (Bucur) 2015; 110 (02) 171-174
    Google Scholar
  • 6 Seo G, Park J, Lee E. et al. Gangliocytic paraganglioma of the gastrointestinal tract: a case report of cecal origin. Curr Med Imaging 2022; 18 (01) 95-98
    CrossrefPubMedGoogle Scholar
  • 7 Matsumoto T, Yamamoto S, Fujita S, Akasu T, Moriya Y. Cecal schwannoma with laparoscopic wedge resection: report of a case. Asian J Endosc Surg 2011; 4 (04) 178-180
    CrossrefPubMedGoogle Scholar
  • 8 Abdalla S, Meillat H, Fillol C. et al. Ileocecal valve sparing resection for the treatment of benign cecal polyps unsuitable for polypectomy. JSLS 2021; 25 (02) e2021.00023
    CrossrefPubMedGoogle Scholar
  • 9 Cho IS, Bae SU, Jung HR, Park KS, Jeong WK, Baek SK. Actinomycosis of the appendix mimicking cecal tumor treated by single-port laparoscopic approach. Ann Coloproctol 2021; 37 (02) 125-128
    CrossrefPubMedGoogle Scholar
  • 10 Sun P, Jiang F, Sun H. et al. Minimally invasive surgery for appendiceal intussusception caused by mucocele of the appendix: case report and review of the literature. J Gastrointest Oncol 2020; 11 (01) 102-107
    CrossrefPubMedGoogle Scholar
  • 11 Sahami S, Kooij IA, Meijer SL, Van den Brink GR, Buskens CJ, Te Velde AA. The link between the appendix and ulcerative colitis: clinical relevance and potential immunological mechanisms. Am J Gastroenterol 2016; 111 (02) 163-169
    CrossrefPubMedGoogle Scholar
  • 12 Palmisano S, Silvestri M, Troian M, Germani P, Giudici F, de Manzini N. Ileocaecal valve syndrome after surgery in adult patients: myth or reality?. Colorectal Dis 2017; 19 (08) e288-e295
    CrossrefPubMedGoogle Scholar
  • 13 Ohigashi S, Hoshino Y, Ohde S, Onodera H. Functional outcome, quality of life, and efficacy of probiotics in postoperative patients with colorectal cancer. Surg Today 2011; 41 (09) 1200-1206
    CrossrefPubMedGoogle Scholar
  • 14 Magdeburg J, Glatz N, Post S, Kienle P, Rickert A. Long-term functional outcome of colonic resections: how much does faecal impairment influence quality of life?. Colorectal Dis 2016; 18 (11) O405-O413
    CrossrefPubMedGoogle Scholar
  • 15 Thompson Jr JE, Bennion RS, Schmit PJ, Hiyama DT. Cecectomy for complicated appendicitis. J Am Coll Surg 1994; 179 (02) 135-138
    PubMedGoogle Scholar