APENDİKS’İN KARSİNOİD TÜMÖRÜ: 3981 APENDEKTOMİ VAKASININ DEĞERLENDİRİLMESİ Carcinoid Tumor Of Appendix: Evaluatıon of 3981 Appendectomy Cases

OZET Amac: Bu calismanin amaci acil apendektomilerde insidental olarak karsilastigimiz apendiks karsinoid tumorlerinin sikligi ve tedavi yontemlerini tartismaktir. Gerec ve Yontem: 2008 Eylul – 2016 Eylul tarihleri arasinda Erzurum Bolge Egitim ve arastirma hastanesinde klinik ve radyolojik olarak Akut apandisit tanisi konularak ameliyata alinan ve patolojik sonucu Akut apandisit olarak rapor edilen 3981 hastanin dosyalari elektronik ortamda incelendi. Patolojik olarak Karsinoid tumor tanisi konulan hastalar analize edildi. Bulgular: 2008 Eylul ayi ile 2016 Agustos aylari arasinda ki 8 yil boyunca toplam 3981 hastaya apendektomi yapildi ve bu hastalarin icerisinde 21(%0.53) hastaya histopatolojik olarak karsinoid tumor tanisi konuldu. Hastalarin 11 i erkek 10 u ise kadindi. Hastalarin yas ortalamasi 33.7 idi. Ameliyattan once hicbir hastaya karsinoid tumor tanisi konulmamisti ve de spesmenlerin ameliyat sonrasi incelenmesi sonucunda tani konulmustu. Hastalarin tumu acil olarak opere edilmisti. Hastalarin hic birinde karsinoid sendrom bulgulari olan diyare ve flushing gibi semptomlar mevcut degildi. Tumor hastalarin 18 inde apendixin Uc kisminda, 2 sinde appendixin ortasinda ve 1 inde de appendixin taban kisminda idi. Tumor capi 12 hastada 1 cm den kucuk, 5 hastada 1-2 cm arasinda ve 4 hastada ise 2 cm den buyuktu. Hastalarin 4 une ikinci bir operasyon gerekmisti ve sag hemikolektomi yapilmisti. Sag hemikolektomi yapilan hastalarin tumor capi 2 cm den buyuktu ve hic birinde uzak metastaz tespit edilmemisti. Sonuc: Karsinoid tumorler apendiksin en sik gorulen tumorudur. Karsinoid tumorler insidental olarak tespit edildiginden dolayi patoloji sonuclari cok iyi takip edilmelidir. Capi 1 cm den kucuk olan tumorlerde apendektomi, 1-2 cm olan tumorlerde; tumor apendixin kokunde degil ve mezoapendix invazyonu yoksa apendektomi, varsa sag hemikolektomi, 2 cm den buyuk olan tumorlerde ise sag hemikolektomi yapilmalidir. Anahtar Sozcu¨kler: Apendix; Karsinoid tumor; Hemikolektomi ABSTRACT Objective: The aim of this study is to discuss the frequency and treatment methods of appendicitis carcinoid tumors that we encounter incidentally in emergency appendectomies. Material and Methods: The files of 3981 patients who were diagnosed as acute appendicitis clinically and radiologically and reported as acute appendicitis as a result of pathology in Erzurum Region Education and Research Hospital between September 2008- September 2016 were rewieved electronically. Patients diagnosed with carcinoid tumor were pathologically analyzed. Findings: A total of 3981 patients underwent appendectomy for 8 years between September 2008 and August 2016 and these patients, 21 (0.53%) were histopathologically diagnosed as carcinoid tumors. 11 of the patients were male and 10 of the patients were female. The mean age of the patients was 33.7. Before the operation, none of the patients had carcinoid tumor diagnosis and the diagnosis was made as a result of examination of the specimens after the operation. All of the patients were operated immediately. Symptoms such as diarrhea and flushing were not present in any of the patients with carcinoid syndrome findings. The tumor was located at the tip of the appendix of 18 patients, in the middle of the appendix of 2 patients and at the base of the appendix of 1 patient. Tumor diameter was smaller than 1 cm in 12 patients, 1-2 cm in 5 patients, and larger than 2 cm in 4 patients. A second operation was required for 4 patients and right hemicolectomy was performed. Patients who underwent right hemicolectomy had a tumor size larger than 2 cm in diameter and no distant metastases were identified. Discussion: Carcinoid tumors are the most common tumor of appendix. Since carcinoid tumors are incidentally identified, the pathology results should be followed very carefully. Appendectomy in tumors smaller than 1 cm in diameter, in 1-2 cm tumors; appendectomy should be performed if the tumor is not at the root of the appendix and if there is no mezoappendix invasion but if there is, right hemicolectomy should be performed in tumors larger than 2 cm in diameter. Keywords: Appendix; Carcinoid tumor; Hemicolectomy