Leebmann H, Piso P
Krankenhaus Barmherzige Brüder Regensburg, Prüfeninger Str. 86, 93049, Regensburg, Deutschland.
Chirurgie (Heidelb). 2022 Dec;93(12):1152-1157. doi: 10.1007/s00104-022-01696-7. Epub 2022 Sep 12.
The term pseudomyxoma peritonei (PMP) describes a clinical syndrome characterized by the presence of gelatinous intraperitoneal accumulation of mucus. It mostly originates from a mucocele of the vermiform appendix. Affected patients are often asymptomatic for a long time. Because of its indolent nature it is usually diagnosed at an advanced stage. Clinical presentation is determined by the dissemination of the tumor.
A search and analysis of the current literature were carried out.
Based on the morphological characteristics PMP subtypes with various malignant potential can be differentiated. The prognosis depends on the histopathological differentiation and the clinical stage. The treatment spectrum varies from laparoscopic appendectomy to complete cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC).
Due to the rarity of PMP there are no prospective randomized studies. Therefore, there is still controversy regarding the best stage-dependent treatment strategy. This review article attempts to clarify the optimal management of mucinous neoplasms of the appendix and PMP taking the clinical presentation and the histological differentiation into consideration.
腹膜假黏液瘤(PMP)一词描述了一种临床综合征,其特征为腹腔内存在胶冻状黏液积聚。它大多起源于阑尾黏液囊肿。受影响的患者通常长期无症状。由于其生长缓慢的特性,通常在晚期才被诊断出来。临床表现取决于肿瘤的播散情况。
对当前文献进行检索和分析。
根据形态学特征,可以区分出具有不同恶性潜能的PMP亚型。预后取决于组织病理学分化程度和临床分期。治疗方法从腹腔镜阑尾切除术到伴有腹腔内热灌注化疗(HIPEC)的完全细胞减灭术(CRS)不等。
由于PMP罕见,尚无前瞻性随机研究。因此,关于最佳的分期依赖性治疗策略仍存在争议。这篇综述文章试图结合临床表现和组织学分化情况,阐明阑尾黏液性肿瘤和PMP的最佳管理方法。