Villous tumors of the duodenum.

Abstract:

:Records of 32 patients with 34 villous and tubulovillous adenomas of the duodenum, treated at the Cleveland Clinic over the past 21 years, were reviewed. Twenty-two patients (69%) had complete resection of the adenoma; the incidence of malignancy was 47%. Five patients underwent a Whipple procedure; 4 patients had segmental resection of the duodenum; 12 had wide local excision of the adenoma; 1 had both a segmental resection and a local excision for two separate adenomas; and 5 patients had endoscopic excision alone. The remaining five patients underwent exploratory laparotomy alone or with palliative bypass procedures. A 28% recurrence rate was observed, all of these after segmental resection, local excision, or endoscopic excision. The highest recurrence rate was associated with local excision. The 2- and 5-year survival rates for patients with adenomas containing invasive cancer were 22% and 0%, respectively, compared to 87% and 87%, respectively, for benign adenomas (including those with carcinoma in situ). Twenty-two per cent of patients had intestinal polyposis syndromes. Duodenal adenomas were diagnosed a mean of 17 years after colectomy for polyposis, indicating the need for continued surveillance in these patients.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Galandiuk S,Hermann RE,Jagelman DG,Fazio VW,Sivak MV

doi

10.1097/00000658-198803000-00002

subject

Has Abstract

pub_date

1988-03-01 00:00:00

pages

234-9

issue

3

eissn

0003-4932

issn

1528-1140

journal_volume

207

pub_type

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  • Management of external gastrointestinal fistulas.

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