Laparoscopy-assisted resection for jejunal carcinoma

A case of jejunal adenocarcinoma diagnosed by preoperative double balloon enteroscopy

Despite a thorough history, physical examination, and complete diagnostic workup, the correct diagnosis of small-intestinal malignancy is established preoperatively in only 50% of cases; an exploratory laparotomy is often required. However, recent advances in endoscopic technologies, such as double-balloon enteroscopy (DBE), have been shown to facilitate the preoperative diagnosis of these tumors. Confirmation of malignancy using DBE in equivocal cases may greatly increase both patients' acceptance of surgery and the confidence of the physician planning a surgical resection. We describe herein the case of a 53-year-old woman with a stage I jejunal adenocarcinoma that was diagnosed by DBE and treated by laparoscopic jejunectomy. Histopathological examination revealed a stage I jejunal adenocarcinoma (T2N0M0) without muscularis propria invasion, lymphovascular invasion, or lymph-node metastasis.

Laparoscopic small bowel resection of metastatic pulmonary carcinosarcoma

Carcinosarcoma of the lung is a rare malignancy consisting of both epithelial and mesenchymal components. Although metastatic disease is common, metastatic disease to the small intestine is rare and has been reported only once in the literature. An unusual case of pulmonary carcinosarcoma with metastasis to the small bowel is presented. At the time of laparoscopic exploration, a 4 x 4 cm mass was seen in the jejunum involving the adjacent mesentery. The affected small bowel and mesentery were resected laparoscopically and bowel continuity was restored through an entirely intracorporeal technique. Laparoscopic small bowel resection can be performed safely in the setting of malignant disease and imparts many of the benefits of minimally invasive surgery.