Beltran Marcelo A, Cruces Karina S
Hospital de Ovalle, Department of Surgery, Ovalle, IV Region, Chile.
Int J Surg. 2007 Jun;5(3):183-91. doi: 10.1016/j.ijsu.2006.05.006. Epub 2006 Jun 12.
Small-bowel tumors are rare and account for 1-2% of all gastrointestinal neoplasms. Most of these tumors are found at surgery indicated for other diagnosis or intestinal obstruction. The rarity, unclear presentation and diagnostic difficulty of these tumors stimulated our interest to review our experience with emergency surgery for intestinal obstruction secondary to jejunoileal tumors.
We reviewed 17 patients operated on for intestinal obstruction secondary to benign and malignant primary tumors of jejunum and ileum at our institution the last 10 years.
The series comprised 8 male and 9 female patients, most of them younger than 49 years of age. The most frequent tumors found were GIST (36%) followed by lymphomas (24%) and adenocarcinomas (18%). Most tumors (65%) were located in the ileum. Mean survival for patients with malignant tumors was 19.5+/-13 months, and for patients with benign tumors 72+/-20 months (p<0.05).
Jejunoileal tumors present frequently in patients younger than 49 years of age. Ileal tumors are more likely to develop intestinal obstruction than jejunal tumors. Emergency surgery for these patients precludes a complete and negative margin resection and constitutes a risk factor for residual disease and short-term survival.
小肠肿瘤较为罕见，占所有胃肠道肿瘤的1% - 2%。这些肿瘤大多在因其他诊断或肠梗阻而进行的手术中被发现。这些肿瘤的罕见性、不明确的表现以及诊断困难激发了我们回顾空肠回肠肿瘤继发肠梗阻急诊手术经验的兴趣。
我们回顾了过去10年在我院因空肠和回肠原发性良恶性肿瘤继发肠梗阻而接受手术的17例患者。
该系列包括8例男性和9例女性患者，大多数年龄小于49岁。最常见的肿瘤是胃肠道间质瘤（GIST，36%），其次是淋巴瘤（24%）和腺癌（18%）。大多数肿瘤（65%）位于回肠。恶性肿瘤患者的平均生存期为19.5±13个月，良性肿瘤患者为72±20个月（p<0.05）。
空肠回肠肿瘤常见于年龄小于49岁的患者。回肠肿瘤比空肠肿瘤更易发生肠梗阻。这些患者的急诊手术无法实现完整的切缘阴性切除，并且是残留疾病和短期生存的危险因素。
