Abstract
BackgroundsThe number of appendectomies and cholecystectomies performed is gradually increasing worldwide. An increasing incidence of colorectal cancer (CRC) after appendectomy and cholecystectomy has been reported, but the location of tumors in certain segments of the colon and rectum after appendectomy and cholecystectomy is still uncertain. We aimed to evaluate the distribution of the locations of colorectal cancer after appendectomy and/or cholecystectomy in patients who underwent CRC surgery.MethodsWe reviewed the medical records of patients who had undergone CRC surgery between 2015 and 2017 for the presence of previous appendectomy/cholecystectomy. Data were collected from the Colorectal Data Base of the University of Szeged, Department of Surgery.ResultsSurgery for CRC was performed in 640 patients during the study period. Data of 604 patients were analyzed. Appendectomy was performed in 100 patients (16.6%), cholecystectomy in 65 (10.8%), and both interventions in 18 (3%) before the CRC surgery. Out of those patients who underwent appendectomy alone, 92 (92%) had undergone appendectomy more than 10 years before the CRC surgery. Also in these 100 patients, the prevalence of right-sided colon cancer (CC) was 35% (n = 35), in comparison with the prevalence among the 504 other patients (20.4%, n = 103). The prevalence of right-sided CC among patients who underwent cholecystectomy alone was 36.9% (n = 24), in comparison with 21.2% (n = 114) of the 539 other patients.ConclusionsA significant left to right side shift in CRC was noted among patients who had previously undergone appendectomy/cholecystectomy. Because right-sided CC has a worse prognosis, the role of incidental appendectomy and routine cholecystectomy seems that need re-evaluation.
Highlights
Colorectal cancer (CRC) was the third most common malignant tumor diagnosed in 2012 worldwide (1.4 million patients) and the fourth most common cause of death (700,000 patients) [1]
We aimed to evaluate the distribution of the locations of colorectal cancer after appendectomy and/or cholecystectomy in patients who underwent CRC surgery
Thirty-six patients were excluded from the study
Summary
Colorectal cancer (CRC) was the third most common malignant tumor diagnosed in 2012 worldwide (1.4 million patients) and the fourth most common cause of death (700,000 patients) [1]. CRC was responsible for approximately 150,000–175,000 deaths annually in the European Union between 2011 and 2018 [2, 3]. The incidence of CRC is expected to increase further. The incidence and rate of mortality due to CRC have increased in most of the countries except in those in which public health measures (such as CRC screening) have been initiated [1]. The prevalence of CRC shows geographical differences and is associated with the degree of industrialization in a country. The risk factors of CRC can be classified as modifiable and non-modifiable. Non-modifiable risk factors include inflammatory bowel diseases, positive family history, age, and gender [4]. Possible additional risk factors of CRC include a history of appendectomy and cholecystectomy [5, 6]
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