Clinicopathological Spectrum, Surgical Management, and Outcomes of Uncommon Surgically Managed Small Intestinal Disorders: A Six-Year Retrospective Observational Study From a Tertiary Care Center.

内容摘要

Background The present study focuses on uncommon surgically managed disorders of the small intestine. Although several of these entities, such as gastrointestinal stromal tumors, Crohn's disease requiring surgery, and symptomatic Meckel's diverticulum, are not classified as rare diseases by epidemiological definitions, they represent infrequently encountered indications for operative management at individual centers. Evaluating these surgically managed conditions together provides insight into diagnostic challenges, operative decision-making, and postoperative outcomes encountered in routine surgical practice. Methodology A retrospective observational study was conducted including all patients with uncommon surgically managed small intestinal disorders between January 2020 and December 2025. Clinical, operative, histopathological, and postoperative outcome data were extracted from institutional medical records. Patients were followed through outpatient records and hospital databases until the last available follow-up (median = 24 months; range = 3-36 months). Continuous variables were analyzed using Student's t-test or Mann-Whitney U test, and categorical variables using the chi-square test or Fisher's exact test, as appropriate. Descriptive statistics with 95% confidence intervals (CIs) were used to summarize clinical outcomes. Results In total, 34 patients were included. The mean age was 46.7 ± 16.4 years, and 70.6% were male (24/34; 95% CI: 52.5%-84.9%). Gastrointestinal stromal tumors were the most common pathology (26.5%; 95% CI: 12.9%-44.4%). Contrast-enhanced computed tomography was performed in all patients (34/34, 100%) and demonstrated the highest radiological-pathological concordance, with the preoperative radiological impression corresponding to the final operative and histopathological diagnosis in 31 of 34 patients (91.2%). Emergency surgery was required in 41.2% of patients (14/34; 95% CI: 24.6%-59.3%). Postoperative morbidity occurred in 11.8% (4/34; 95% CI: 3.3%-27.5%), with no postoperative mortality. During a mean follow-up of 21.4 ± 8.6 months, symptom resolution occurred in 94.1% (32/34; 95% CI: 80.3%-99.3%), disease recurrence in 5.9% (2/34; 95% CI: 0.7%-19.7%), diagnosis-specific follow-up outcomes in 94.1% (95% CI: 80.3%-99.3%), and overall survival in 100% (95% CI: 89.7%-100%). Conclusions Uncommon surgically managed small intestinal disorders encompass a heterogeneous group of congenital, inflammatory, vascular, and neoplastic conditions that present substantial diagnostic and therapeutic challenges. Timely diagnosis and definitive surgical management are associated with favorable postoperative outcomes; however, disease-specific interpretation remains important because of the heterogeneity of the cohort.