TY - JOUR
T1 - Primary jejunoileal tumors
T2 - A review of 45 cases
AU - Desa, L. A.J.
AU - Bridger, J.
AU - Grace, P. A.
AU - Krausz, T.
AU - Spencer, J.
PY - 1991/1
Y1 - 1991/1
N2 - We reviewed 45 patients who underwent surgery for primary jejunoileal tumors over a 15-year period. There were 16 benign and 29 malignant tumors, which included 13 lymphomas, 7 adenocarcinomas, 7 carcinoid tumors, and 2 leiomyosarcomas. Eighteen patients, 13 of whom had benign tumors, presented with intestinal bleeding and 5 tumors were found incidentally at laparotomy. Benign lesions were more frequently sited in the jejunum while malignant lesions were more common in the ileum (p<0.001). Lesions presenting with hemorrhage were more likely to be benign than malignant (p<0.001) and were more commonly sited in the jejunum than in the ileum (p<0.05). Visceral perforation (31%), intestinal obstruction (21%), and an abdominal mass (17%) were other presenting features in patients with malignant tumors. In spite of a wide variety of investigations, the correct diagnosis was reached preoperatively in only 31% of patients. Surgical management included either limited bowel resection or segmental resection with regional lymphadenectomy. Operative mortality was 13% and morbidity was 36%. Actuarial 5-year survival for all malignant tumors was 24%, being 64% at 5 years for carcinoid tumors, 20% at 30 months for adenocarcinomas, and 10% at 42 months for lymphomas. These results reemphasize the need for a high index of suspicion and early laparotomy in patients with obscure intestinal symptoms if the prognosis of small bowel tumors is to improve.
AB - We reviewed 45 patients who underwent surgery for primary jejunoileal tumors over a 15-year period. There were 16 benign and 29 malignant tumors, which included 13 lymphomas, 7 adenocarcinomas, 7 carcinoid tumors, and 2 leiomyosarcomas. Eighteen patients, 13 of whom had benign tumors, presented with intestinal bleeding and 5 tumors were found incidentally at laparotomy. Benign lesions were more frequently sited in the jejunum while malignant lesions were more common in the ileum (p<0.001). Lesions presenting with hemorrhage were more likely to be benign than malignant (p<0.001) and were more commonly sited in the jejunum than in the ileum (p<0.05). Visceral perforation (31%), intestinal obstruction (21%), and an abdominal mass (17%) were other presenting features in patients with malignant tumors. In spite of a wide variety of investigations, the correct diagnosis was reached preoperatively in only 31% of patients. Surgical management included either limited bowel resection or segmental resection with regional lymphadenectomy. Operative mortality was 13% and morbidity was 36%. Actuarial 5-year survival for all malignant tumors was 24%, being 64% at 5 years for carcinoid tumors, 20% at 30 months for adenocarcinomas, and 10% at 42 months for lymphomas. These results reemphasize the need for a high index of suspicion and early laparotomy in patients with obscure intestinal symptoms if the prognosis of small bowel tumors is to improve.
UR - http://www.scopus.com/inward/record.url?scp=0026088893&partnerID=8YFLogxK
U2 - 10.1007/BF01658970
DO - 10.1007/BF01658970
M3 - Review article
C2 - 1994611
AN - SCOPUS:0026088893
SN - 0364-2313
VL - 15
SP - 81
EP - 86
JO - World Journal of Surgery
JF - World Journal of Surgery
IS - 1
ER -