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Surgery for Cancers of the Gastrointestinal Tract pp 149–155Cite as

Open Technique for Resection of Cancers of the Jejunum and Ileum

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Abstract

Although relatively rare, the incidence of small bowel cancer has steadily increased over the past two decades. The most common tumors of the small intestine include: adenocarcinoma, gastrointestinal stromal tumors, lymphomas, and gastrointestinal neuroendocrine tumors. These tumors often remain asymptomatic until late in their course, which makes timely diagnosis difficult. For most small bowel tumors, surgical resection in a timely manner remains the only potentially curative treatment option. The principles of surgical treatment include thorough exploration of the abdomen to identify the primary tumor and any metastatic disease followed by wide en bloc resection of the primary tumor. Bowel continuity is then achieved through an isoperistaltic anastomosis.

Keywords

  • Small bowel cancer
  • Open resection
  • Jejunum
  • Ileum
  • Technique

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Author information

Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, University of Cincinnati Medical Center, 234 Goodman Street, ML 0772, Cincinnati, OH, 45219, USA

    Gregory C. Wilson M.D. & Syed A. Ahmad M.D.

Authors
  1. Gregory C. Wilson M.D.
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  2. Syed A. Ahmad M.D.
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Corresponding author

Correspondence to Syed A. Ahmad M.D. .

Editor information

Editors and Affiliations

  1. Division of Surgical Oncology, City of Hope, Los Angeles, California, USA

    Joseph Kim

  2. Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    Julio Garcia-Aguilar

Key Operative Steps

Key Operative Steps

  1. 1.

    Exploratory laparotomy to identify primary tumor and assess for multicentric and metastatic disease.

  2. 2.

    Perform wide en bloc resection of primary tumor with 6 cm margins.

  3. 3.

    Resect adjacent mesentery and adherent structures.

  4. 4.

    Reestablish bowel continuity with hand-sewn two-layer anastomosis: outer interrupted layer with 3–0 silk suture and inner running layer with 3–0 absorbable suture.

  5. 5.

    Alternatively, reestablish bowel continuity with stapled side-to-side enteroenterostomy using GIA linear stapler (1.5 mm closed staple height). Close enterotomy with 3–0 silk sutures.

  6. 6.

    Close mesenteric defect with simple interrupted sutures to prevent herniation.

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Wilson, G.C., Ahmad, S.A. (2015). Open Technique for Resection of Cancers of the Jejunum and Ileum. In: Kim, J., Garcia-Aguilar, J. (eds) Surgery for Cancers of the Gastrointestinal Tract. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1893-5_13

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  • DOI: https://doi.org/10.1007/978-1-4939-1893-5_13

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