title: A clinical case of duodenal gastrointestinal stromal tumor with a peculiarity in the surgical approach.
abstract: We describe a case of duodenal, third portion, segmental resection for gastrointestinal stromal tumor. A 76-year-old man was referred for gastrointestinal bleeding, dyspnea and asthenia. Esophagogastroduodenoscopy showed a duodenal bleeding fistula. Computerized tomography demonstrated a retroperitoneal mass that compressed and displaced forward the third duodenal tract. Segmental resection of the third portion of the duodenum with a subtotal gastrectomy was performed. The patient was reconstructed with a termino-terminal duodenal anastomosis of the second and the fourth tract and with a Roux-en-Y gastrojejunum anastomosis. There were no postoperative complications. This duodenectomy procedure could be useful as a less extensive resection for duodenal gastrointestinal stromal tumor located in the third portion of the duodenum when the tumor is well capsulated, when the surrounding structures are not infiltrated and when there are no vascular difficulties. The technique reduces the morbidity and mortality correlated with duodenocefalopancreasectomy and improves postsurgical quality of life without worsening the risk of recurrence.
authors.affiliation: Department of General Surgery and Oncology, University of Siena, Unit of Surgical Oncology, Siena, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: De Marco
authors.forename: Franco
authors.initials: F
authors.lastname: Roviello
authors.forename: Daniele
authors.initials: D
authors.lastname: Marrelli
authors.forename: Alfonso
authors.initials: A
authors.lastname: De Stefano
authors.forename: Alessandro
authors.initials: A
authors.lastname: Neri
authors.forename: Simone
authors.initials: S
authors.lastname: Rossi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corso
authors.forename: Bernardino
authors.initials: B
authors.lastname: Rampone
authors.forename: Giacomo
authors.initials: G
authors.lastname: Nastri
authors.forename: Enrico
authors.initials: E
authors.lastname: Pinto
mesh_terms: D000368:Aged; D000713:Anastomosis, Roux-en-Y; D004379:Duodenal Neoplasms / Q000473:pathology* / Q000601:surgery*; D016145:Endoscopy, Digestive System; D005743:Gastrectomy; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007583:Jejunum / Q000601:surgery; D008297:Male; D011788:Quality of Life; D013270:Stomach / Q000601:surgery; D016896:Treatment Outcome