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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(08): E932-E939
DOI: 10.1055/a-2356-6711
Original article

Transcecal endoscopic appendectomy for management of complex appendiceal polyps extending into the appendiceal orifice

Tara Keihanian
1   Gastroenterology and Hepatology, Baylor College of Medicine, Houston, United States (Ringgold ID: RIN3989)
,
Mai A Khalaf
1   Gastroenterology and Hepatology, Baylor College of Medicine, Houston, United States (Ringgold ID: RIN3989)
,
Fuad Zain Aloor
2   Medicine, Baylor College of Medicine, Houston, United States (Ringgold ID: RIN3989)
,
Dina Hani Zamil
2   Medicine, Baylor College of Medicine, Houston, United States (Ringgold ID: RIN3989)
,
Salmaan Jawaid
1   Gastroenterology and Hepatology, Baylor College of Medicine, Houston, United States (Ringgold ID: RIN3989)
,
Mohamed O. Othman 
1   Gastroenterology and Hepatology, Baylor College of Medicine, Houston, United States (Ringgold ID: RIN3989)
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Abstract

Background and study aims Endoscopic resection of appendiceal orifice (AO) polyps extending inside the appendiceal lumen is challenging given the inability to determine polyp lateral margins and risk of appendicitis. Transcecal endoscopic appendectomy (TEA) ensures en bloc resection of these complex polyps.

Patients and methods This case series includes patients who underwent TEA by a single endoscopist in the United States. Technical success was defined as achieving complete removal of the appendix along with AO polyp in an en bloc fashion.

Results In total, nine patients were included (mean age 69.7 ± 9.6 years). The average appendix size was 4.07 ± 2.02 cm. Technical success was achieved in 100% of the patients. The average procedure length was 118.1 ± 44.21 minutes. The en bloc resection rate, R0 resection rate, and curative resection rates were 100%. Patients were observed for an average of 3.1 ± 1.6 days. One patient developed loculated fluid collection 9 days post procedure, which resolved on its own with oral antibiotic therapy. No other adverse events were recorded.

Conclusions This was an early study of the feasibility of TEA in the United States. This novel technique, in early-stage development, is potentially safe and associated with a minimal risk profile in expert hands. Further prospective studies are needed to standardize the technique.

Keywords

Endoscopy Lower GI Tract - Polyps / adenomas / ... - Endoscopic resection (polypectomy, ESD, EMRc, ...)


Publication History

Received: 14 January 2024

Accepted after revision: 20 June 2024

Article published online:
08 August 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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