Tumors of the small intestine. Experience of treatment in the emergency surgery department

Abstract

Tumors of the small intestine account for only 1–3% of all gastrointestinal neoplasms, but their diagnosis remains challenging due to nonspecific symptoms and diagnostic difficulties. Most patients present with complications (intestinal obstruction, bleeding), which worsens the prognosis. Objective: to analyze the clinical features, diagnostic methods, and outcomes of surgical treatment for small intestine neoplasms, as well as to propose ways to improve early detection. Materials and methods. A retrospective analysis was conducted on 26 patients (mean age 55.7±2.5 years) treated at St Petersburg City Hospital No. 40 (2010–2023). The main diagnostic methods included oral contrast-enhanced computed tomography (70% efficacy), endoscopy (EGD, colonoscopy, capsule endoscopy, enteroscopy), and histological examination of the lesions. Statistical analysis was performed using Excel 365 and SPSS Statistics Version 26. Results. 57.7% of patients were admitted with intestinal obstruction, 26.9% with bleeding, and 11.5% with perforation. The tumor was localized in the jejunum in 38.5% of cases and in the ileum in 38.5%. Histological examination revealed adenocarcinoma in 34.6% of patients, neuroendocrine tumors in 19.2%, GIST in 11.5%, and lymphoma in 7.7%. Small intestine R0 resection was performed in 73.1% of cases. Mortality was 7.7% (2 cases due to perforated peritonitis). Postoperative complications included wound suppuration (7.7%) and adhesive obstruction (3.8%). The overall one-year survival rate was 80.8%, and the five-year survival rate was 57.7%. Statistical analysis did not reveal a significant correlation between clinical presentation, tumor location, histological type, or tumor stage (p>0.05). Conclusion. Small intestine tumors are often diagnosed at late stages due to the absence of early symptoms. Surgical treatment remains the primary method, but its effectiveness depends on timely diagnosis. The introduction of enteroscopy and improved access to CT could enhance detection rates. Further research is needed to develop standardized management algorithms for these patients.