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Surgical Management of Jejunal Tumors: Experience from Tertiary Care Centre

  • Harjeet SinghEmail author
  • Gautham Krishnamurthy
  • Hemanth Kumar
  • Harshal Mandavdhare
  • Vishal Sharma
  • Thakur Deen Yadav
Original Research

Abstract

Introduction

Small bowel is an uncommon site for primary neoplasm in the gastrointestinal tract. Traditionally, duodenum has been combined with jejunum and ileum in analysing the presentation and management of these tumors. Given the different presentation pattern, diagnostic difficulties and anatomical considerations, jejunal tumors may differ from duodenal tumors.

Methodology

Retrospective analysis of a prospectively maintained database of patients with histology proven jejunal tumors was done. Clinico-radiological characters, histological findings, surgical procedures and the outcomes in these patients were studied.

Results

Sixteen patients were included in the study. Median age at presentation was 42 years (26–76 years) and majority were males (n = 11, 68.8%). Seven (43.7%) patients presented with emergencies. Endoscopic tissue diagnosis could be obtained in 5 (31.3%) patients. Histology of tumors were adenocarcinoma, gastrointestinal stromal tumor and lymphoma in 6 (37.5%), 5 (31.3%) and 3 (18.8%) respectively. Sarcoma (myxofibroma) and metastasis (urothelial origin) were present in one patient each. Two patients with adenocarcinoma had neoadjuvant chemotherapy. Curative resection was feasible in 14 patients. Resection of tumor-bearing segment with anastomosis was performed in 9 patients. Among these, 5 had duodenojejunostomy. One patient had resection and double-barrel jejunostomy. One patient with jejunal GIST had sleeve resection. Multi-visceral resection was performed in 3 patients. There were no mortality and median postoperative hospital stay was 11 days (range 7–33 days).

Conclusion

Histology spectrum of jejunal tumors are distinct. Difficulty in obtaining preoperative tissue diagnosis of these lesions need to be addressed by improved endoscopic and image-directed biopsy techniques.

Keywords

Small-bowel tumors Jejunal tumors Adenocarcinoma Duodenojejunal flexure 

Notes

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of General SurgeryPost Graduate Institute of Medical Education and ResearchChandigarhIndia
  2. 2.Department of GastroenterologyPost Graduate Institute of Medical Education and ResearchChandigarhIndia

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