Surgery

Surgical resection is the most important therapy for all small bowel tumours. All benign tumours, such as leiomyomas, small bowel adenomas, angiomas, and lipomas, can be cured by adequate segmental resections with clear serosal margins. The same holds true for the malignant tumours, although surgery should include lymph node resection.

Pancreaticoduodenectomy may be required in patients with tumours arising in the proximal and second portion of the duodenum. Carcinoid tumours confined to the distal ileum require resection that sometimes includes part of the caecum. In patients with Peutz-Jeghers' syndrome and multiple polyps only limited resection should be performed and most of the tumours can be removed by endoscopic polypectomy.

Resection of involved bowel is recommended for lymphomas, except the Mediterranean type, that often involves the entire small bowel and responds to systemic therapy.

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