Primary Small-Bowel Tumors; Our Clinical and Surgical Experience

INTRODUCTION: Small bowel tumors are rare lesions and they constitute less than 5% of all gastrointestinal system (GIS) tumors. Diagnosis of small bowel tumors is very difficult due to nonspecific clinical findings. The aim of this study is to evaluate the data of patients with primary small bowel tumors who underwent surgical treatment in our clinic.
METHODS: Thirty-five primary small bowel tumor cases operated in Dicle Hospital between January 2011 and December 2020 were retrospectively analyzed. The patients were evaluated in terms of age, gender, admission complaint, operative finding, surgical method, pathological findings, morbidity and mortality. The results of the patients were obtained from the file records and/or interviews with the patients.
RESULTS: Twenty-two (62.9%) cases were female and 13 (37.1%) were male, with a mean age of 53.9 (21-79). Abdominal pain was present in all cases. Abdominal distension was seen in 15 (42.9%) cases, vomiting in 10 (28.6%) cases, invagination findings in 5 (14.3%) cases, GIS perforation in 4 (11.4%) cases, GIS bleeding in 2 (5.7%) cases. Abdominal computed tomography (CT) was used as the imaging method in all patients. The mean time between the onset of complaints and diagnosis was 1.6 (1-15) months. Laparoscopic surgery was used in six (17.1%) cases, and open surgery was used in others. Tumors were mostly located in the jejunum (68.6%). The most common type was adenocarcinoma (34.3%) detected in the postoperative histopathological examination. Mortality was observed in 3 (8.6%) cases in the 6-month postoperative follow-up.
DISCUSSION AND CONCLUSION: Small intestinal tumor is a rare condition. Preoperative diagnosis is difficult due to the nonspecific nature of the symptoms. If there is high doubt in the diagnosis, surgical intervention should not be postponed.

Primer Ýnce Barsak Tümörleri; Klinik ve Cerrahi Deneyimimiz

GÝRÝÞ ve AMAÇ: Ýnce barsak tümörleri nadir görülen lezyonlar olup tüm gastrointestinal sistem (GÝS) tümörlerinin %5’ inden daha azýný oluþtururlar. Nonspesifik klinik bulgularýna baðlý olarak ince barsak tümörlerinin tanýsý oldukça güçtür. Bu çalýþmanýn amacý, kliniðimizde cerrahi tedavi uygulanan primer ince barsak tümörlü hastalarýn verilerinin deðerlendirilmesidir.
YÖNTEM ve GEREÇLER: Ocak 2011- Aralýk 2020 yýllarý arasýnda Dicle Üniversitesi hastanesinde opere edilen 35 primer ince barsak tümör vakasý geriye dönük olarak incelendi. Hastalarda yaþ, cinsiyet, baþvuru þikâyeti, operasyon bulgusu, uygulanan cerrahi yöntem, patolojik bulgular, morbidite ve mortalite açýsýndan deðerlendirildi. Hastalarýn sonuçlarý dosya kayýtlarýndan ve/veya hastalarla görüþülmesi sonucunda elde edildi.
BULGULAR: Olgularýn 22 ‘si (%62.9) kadýn, 13’ü erkek (%37.1) olup, ortalama yaþlarý 53.9 (21- 79) idi. Tüm olgularda karýn
aðrýsý mevcuttu. 15 (%42.9) olguda abdominal distansiyon, 10 (%28.6) olguda kusma, 5 (%14.3) olguda invaginasyon bulgularý, 5 (%14.3) olguda GÝS perforasyonu, 2 (%5.7) olguda GÝS kanamasý görüldü. Bütün hastalarda görüntüleme yöntemi olarak karýn bilgisayarlý tomografisi (BT) kullanýldý. Þikayetlerin baþlamasý ile taný konulmasý arasýnda geçen süre ortalama 1.6 (1-15) aydý. Altý (%17.1) olguda laparoskopik cerrahi yöntem, diðerlerinde açýk cerrahi yöntem uygulandý. Tümörler daha çok jejunum (%68.6) yerleþimli idi. Postoperatif histopatolojik incelemede en sýk adenokarsinom (%34.3) tespit edildi. Postoperatif 6 aylýk takipte 3 (%8.6) olguda mortalite gözlendi.

TARTIÞMA ve SONUÇ: Ýnce baðýrsak tümörü nadir görülen bir durumdur. Semptomlarýn nonspesifik oluþu nedeniyle preoperatif taný koymak zordur. Tanýda yüksek þüphe varsa cerrahi müdahale ertelenmemelidir.