Is Duodenojejunal Anastomosis to the Left of the Superior Mesenteric Vessels a Feasible Option for Tumors of the Angle of Treitz?

Caruso, Francesco; Nencioni, Marco; Zefelippo, Arianna; Rossi, G.; Caccamo, L.

doi:10.5301/tj.5000391

Cited by 2 publications

(4 citation statements)

References 5 publications

(3 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Third and fourth duodenal portions:  segmental resection with closure of distal stump and side-to-side (93) or end-to-side/end-to-end duodenojejunostomy (62,92);  segmental resection, end-to-end anastomosis, pylorus closure and gastroenterostomy with/without feeding jejunostomy (77);  segmental resection, closure of distal stump near leg. Treitz and end-to-side duodenojejunostomy with first jejunal loop (99);  segmental resection with end-to-side or endto-end duodenojejunostomy to the left of the superior mesenteric vessels (66,72,75) segmental resection, closure of distal stump on the right of superior mesenteric vessels, papilloplasty, endto-side duodenojejunostomy, transcystic tube and transjejunal tubes draining the main pancreatic duct and decompressing duodenum (38);  segmental resection of third and fourth part of duodenum, closure of second portion stump and side-to-end duodenojejunostomy (49);…”

Section: Surgical Treatmentmentioning

confidence: 99%

Surgical treatment of gastrointestinal stromal tumors of the duodenum: a literature review

Popivanov¹,

Tabakov²,

Mantese³

et al. 2018

Transl. Gastroenterol. Hepatol

View full text Add to dashboard Cite

Background: Gastrointestinal stromal tumors (GIST) are the most frequent mesenchymal tumours in the digestive tract. The duodenal GIST (dGIST) is the rarest subtype, representing only 4-5% of all GIST, but up to 21% of the resected ones. The diagnostic and therapeutic management of dGIST may be difficult due to the rarity of this tumor, its anatomical location, and the clinical behavior that often mimic a variety of conditions; moreover, there is lack of consent for their treatment. This study has evaluated the scientific literature to provide consensus on the diagnosis of dGIST and to outline possible options for surgical treatment.Methods: An extensive research has been carried out on the electronic databases MEDLINE, Scopus, EMBASE and Cochrane to identify all clinical trials that report an event or case series of dGIST.Results: Eighty-six studies that met the inclusion criteria were identified with five hundred forty-nine patients with dGIST: twenty-seven patients were treated with pancreatoduodenectomy and ninety-six with only local resection (segmental/wedge resections); in four hundred twenty-six patients it is not possible identify the type of treatment performed (pancreatoduodenectomy or segmental/wedge resections).Conclusions: dGISTs are a very rare subset of GISTs. They may be asymptomatic or may involve symptoms of upper GI bleeding and abdominal pain at presentation. Because of the misleading clinical presentation the differential diagnosis may be difficult. Tumours smaller than 2 cm have a low biological aggressiveness and can be followed annually by endoscopic ultrasound. The biggest ones should undergo radical surgical resection (R0). In dGIST there is no uniformly adopted surgical strategy because of the low incidence, lack of experience, and the complex anatomy of the duodenum. Therefore, individually tailored surgical approach is recommended. R0 resection with 1-2 cm clear margin is required. Lymph node dissection is not recommended due to the low incidence of lymphatic metastases. Tumor rupture should be avoided.

show abstract

Section: Surgical Treatmentmentioning

confidence: 99%

Surgical treatment of gastrointestinal stromal tumors of the duodenum: a literature review

Popivanov¹,

Tabakov²,

Mantese³

et al. 2018

Transl. Gastroenterol. Hepatol

View full text Add to dashboard Cite

show abstract

“…PD with regional lymph node dissection has been initially suggested as a standard treatment for AT adenocarcinoma [ 27 , 28 ]. Given the high morbidity rate of PD, a SR including the third and fourth duodenal portions and at least 10 cm of the first jejunal loop has been proposed [ 4 , 5 , 27 , 29 – 32 ]. Indeed, similar mortality and morbidity rates between PD and SR have been reported by some authors [ 31 – 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…Due to their rarity and the variety of histotypes, the surgical treatment of AT tumours is not yet well defined. As reported in Table 4, only seven case reports and one case series of 13 patients (with a laparotomic approach) have been published on this topic since 1951 [3][4][5][6][19][20][21][22]. Other cases were reported in the context of larger series concerning the treatment of different duodenal tracts [23,24].…”

Section: Discussionmentioning

confidence: 99%

“…Both segmental resection (SR) and pancreaticoduodenectomy (PD) have been proposed. Few case reports and one case series suggest an open SR as the treatment of choice, associated or not with a multi-visceral resection [3][4][5][6]. However, there is a great variability in the type of resection and subsequent reconstruction among the studies.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Laparoscopic segmental resection for tumours of the Angle of Treitz: a challenging but feasible surgical option. Results from a retrospective case-series analysis

et al. 2020

View full text Add to dashboard Cite

Tumours of the small intestine are rare and account for about 5% of gastrointestinal tract neoplasms. The angle of Treitz (AT) could be defined as the intestinal loop comprised between the third duodenal portion and the first 10 cm of jejunum. A gold standard surgical treatment for AT neoplasm has not yet been well defined. This paper is focused on a very rare disease and at the best of our knowledge this is the largest case series in the literature about the Laparoscopic Segmental Resection (LSR) of AT tumours. Using a prospectively collected database, all data of consecutive patients, from January 2007 to May 2019, who underwent LSR for AT tumours at two different institutions were analysed. Patients’ demographics, intra and post-operative data, 30-day mortality and overall survival were collected. A total of 16 patients were retrieved from our database. The mean operative time was 206,5 ± 79 min. Conversion to open surgery was needed in two cases due to tumor size and, respectively, invasion of the transverse colon which required a multivisceral resection. The mean distal and proximal resection margins were 7.4 ± 2.2 and 3.9 ± 1.2 cm. The median number of harvested nodes was 9 ± 3. Pathological diagnosis was GIST in 11 cases, adenocarcinoma in 4 and sarcoma in 1 case. In conclusion, in experienced hands, LSR appears to be a safe and effective treatment option for tumours of the AT. Prospective studies are needed to confirm these findings.

show abstract

Is Duodenojejunal Anastomosis to the Left of the Superior Mesenteric Vessels a Feasible Option for Tumors of the Angle of Treitz?

Cited by 2 publications

References 5 publications

Surgical treatment of gastrointestinal stromal tumors of the duodenum: a literature review

Surgical treatment of gastrointestinal stromal tumors of the duodenum: a literature review

Laparoscopic segmental resection for tumours of the Angle of Treitz: a challenging but feasible surgical option. Results from a retrospective case-series analysis

Contact Info

Product

Resources

About