Single-Incision Laparoscopic Ieocecal Resection for Intra-appendiceal Polyp with Malignant Potential

摘要

Due to the presence of fecal occult blood, a 71-year-old man underwent colonoscopy, which demonstrated a 1-cm polyp at the orifice of the vermiform appendix. Endoscopic resection was impossible because the polyp moved in and out of the appendiceal lumen. Laboratory examination at colonoscopy revealed a serum p53 antibody level of 6.38 U/ml (normal <1.30U/ml), while all other blood test results were unremarkable. Although endoscopic biopsy did not show malignancy, surgical treatment was judged necessary because malignancy could not be ruled out. To treat the appendiceal lesion, laparoscopic ileocecal resection with lymph node dissection was performed by means of single-incision laparoscopic surgery. The duration of the operation was 150 minutes, and perioperative blood loss was 40 ml. The postoperative course was uneventful, and the patient was discharged 10 days after the operation. The surgical specimen showed invagination and inversion of a portion of the appendix due to a pedunculated polyp. The pathological diagnosis was high-grade adenoma.