Surgical management of superficial non-ampullary duodenal tumors

Dig Endosc. 2014 Apr:26 Suppl 2:57-63. doi: 10.1111/den.12272.

Abstract

Background and aim: We present our experiences with the so-called 'limited resections' such as transduodenal excision and local full-thickness resection for superficial non-ampullary duodenal tumors (SNADT). The optimal surgical management for SNADT is also discussed.

Methods: Six patients with SNADT (adenoma, n=1; mucosal carcinomas, n=2; submucosal carcinoma, n=1; carcinoids, n=2) were included in this study. Four patients underwent transduodenal excision, one local full-thickness resection, and one laparoscopy-assisted endoscopic full-thickness resection as a modification of local full-thickness resection.

Results: All patients were successfully treated by these limited resections without any adverse events.

Conclusions: Surgical resection is the treatment of choice for SNADT not amenable to endoscopic resection in terms of technical and/or oncological reasons. However, the optimal surgical management for SNADT remains controversial because of the complexity of the relevant anatomy of the duodenum, its rarity, the not well-known incidence of nodal metastasis, and the wide spectrum of pathologies that can be encountered.

Keywords: duodenal tumor; limited resection; local full-thickness resection; surgical management; transduodenal excision.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biopsy, Needle
  • Duodenal Neoplasms / mortality
  • Duodenal Neoplasms / pathology*
  • Duodenal Neoplasms / surgery*
  • Duodenoscopy / methods*
  • Female
  • Humans
  • Immunohistochemistry
  • Intestinal Mucosa / pathology
  • Intestinal Mucosa / surgery
  • Laparoscopy / methods*
  • Laparotomy / methods*
  • Length of Stay
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Operative Time
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Sampling Studies
  • Survival Rate
  • Treatment Outcome