Abnormality of Appendix in Incidental Appendectomy during Colorectal Cancer Surgery

Abstract

Purpose. Incidental appendectomy is a frequent but non-standard procedure during colorectal surgery. The purpose of this study was to evaluate the incidence of abnormal pathological findings of appendix in incidental appendectomy during colorectal cancer surgery and to determine its clinical significance. Methods. A retrospective review of patients who were diagnosed with colorectal cancer and underwent oncological resection of the tumor together with incidental appendectomy at the department of colorectal surgery of our hospital between 2003 and 2012. The histological findings of 1,375 cases of incidental appendectomies during colorectal cancer surgery were analyzed and reviewed. Results. This study included 1,375 patients with a mean age of 61 ± 12 years (range 20-94). Among them, 58.8% were male, 6.91% (95 patients) had fecalith, 0.36% (5 patients) had neuroendocrine tumor, 0.15% (2 patients) had mucinous cystadenoma and 0.87% (12 patients) had synchronous metastatic colorectal cancer in the appendix. Abnormal pathologic alteration was found in 240 patines (17.45%) and a neoplasm was found in 19 patients (1.38%). No complication occurred from the incidental appendectomy. Conclusions. Incidental appendectomy is a safe procedure and may be performed with colorectal cancer surgery to reduce the incidence of appendiceal neoplasm and prevent appendicitis in the future. Patient having colorectal carcinoma should undergo incidental appendectomy because the incidence of synchronous appendiceal neoplasm is not rare (1.38 percent). Metachronous neoplasm is a risk in the retained appendix in patients with colorectal cancer. Appendiceal fecaliths appear to play a role in the pathogenesis of acute appendicitis and are associated with complicated appendicitis. In conclusion, incidental appendectomy may be beneficial for patients undergoing colorectal cancer surgery.