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OPCIONES TERAPÉUTICAS EN LOS TUMORES APENDICULARES

Authors: Paredes, Kimberly Marlit Torres; Oviedo, Carla Daniela Bastidas; Murillo, Luis Enrique Castillo; Arteaga, Norly Elba Adriana Andrade; Rivas, Giselle Alejandra Avila;

OPCIONES TERAPÉUTICAS EN LOS TUMORES APENDICULARES

Abstract

Los tumores del apéndice cecal generalmente son asintomáticos, aunque en ocasiones pueden provocar obstrucción de la luz y originar un cuadro de apendicitis aguda. El diagnóstico es incidental durante el acto quirúrgico. Este tipo de tumor se observa en el 1% de todas las apendicectomías y constituyen el 0.5% de los tumores intestinales. Suelen localizarse en el tercio distal del apéndice. El tipo histológico es variable, pueden ser benignos y malignos; de estos, el tumor carcinoide representa el 20% y a su vez el 16% de los tumores carcinoides gastrointestinales. Los tumores apendiculares menores de 2 cm se observan en el 95% de los casos y en raras ocasiones presentan metástasis, mientras que hasta un tercio de los mayores de 2 cm presentan metástasis. La actitud terapéutica que asume el cirujano depende del tamaño del tumor; los menores de 1 cm se tratan con apendicectomía simple, mientras que en los tumores mayores de 2 cm se debe practicar una hemicolectomía derecha con linfadenectomía. En los tumores entre 1 y 2 cm, el tratamiento debe ser individualizado en cada paciente. En otros casos, en los que el tumor está próximo a la base del apéndice cecal, con invasión vascular o linfática y/o infiltración del meso apéndice, y además los márgenes son positivos o dudosos, se aconseja practicar hemicolectomía derecha. La evolución es favorable si se tratan adecuadamente, es decisiva la conducta que asume el cirujano.

Keywords

apéndice cecal, tumor gastrointestinal, tumor carcinoide

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This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
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This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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