Surgery for Neuroendocrine Tumors of the GI Tract

Minimally Invasive Approach

At Scott & White, most of our operations to remove neuroendocrine tumors of the GI tract are performed with minimally invasive techniques. Benefits of minimally invasive surgery include:

  • Better cosmetic result
  • Quicker recovery times, allowing you to:
    • Return to your daily routine sooner
    • Begin future treatment sooner
  • Shorter hospital stay
  • Less pain
  • Less blood loss
  • Lower risk of infection
  • Fewer complications

Not all patients are candidates for a minimally invasive approach. Factors affecting the decision to use minimally invasive techniques include:

  • Tumor size, stage or location
  • Patient obesity and health
  • Prior surgeries

Your Integrated Care Team may recommend the surgical removal of your neuroendocrine tumor of the gastrointestinal tract. Your physician team may recommend other treatments in addition to surgery.

We use minimally invasive techniques whenever possible and appropriate, based on your condition.

At Scott & White, treatment goals for NETs generally are centered on preserving the functionality of your digestive system. Our philosophy is to preserve as much of your GI tract as reasonable while removing as much cancer as possible.

Your treatment choices often depend on whether your NET is a carcinoid tumor or an islet cell tumor of the pancreas.

Surgical Procedures

Surgery is often the first treatment approach for neuroendocrine tumors of the GI tract.

In most cases, your endocrine surgeon will remove your tumor and surrounding lymph nodes. Your physician may recommend other treatments in addition to surgery.

Your operation will be performed using one of the following methods:

  • Traditional open surgery
  • Traditional laparoscopic surgery

Your physician will discuss which option is best for you.

As with all operations, there are some risks. Your surgeon will discuss those risks with you.

Carcinoid Tumors of the GI Tract

Local Excision

In this minimally invasive surgical procedure, your surgeon will remove your carcinoid tumor, nearby lymph nodes and a narrow margin of surrounding tissue.

If your tumor is located in your rectum, your tumor may be removed through your anus with an endoscope (a very small high-definition camera and cutting tool attached to a thin tube).

Local excision is usually performed to remove carcinoid tumors that are ¾ of an inch or smaller.

Resection

In this surgical procedure, your surgeon will remove all or part of the organ where your tumor is located. Resections are generally recommended for carcinoid tumors larger than ¾ of an inch.

If your tumor is located in your bowel (large intestine), in some cases, your endocrine surgeon will remove a portion of your bowel and surrounding lymph nodes. Your surgeon will reattach your bowel.

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Islet Cell Tumors of the Pancreas

Enucleation

In this surgical procedure, your surgeon will remove just the tumor itself from your pancreas using either a laparoscopic or open approach. This procedure is often recommended with islet cell tumors smaller than 2 inches.

Whipple Procedure (Pancreaticduodenectomy)

If your tumor is located at the head of your pancreas, your surgeon may perform a Whipple procedure, or the surgical removal of only the head of the pancreas (sparing the remainder of your pancreas) and:

  • Part of your small intestine
  • The lower part of your bile duct
  • Part of your stomach

Your surgeon will reconnect your digestive and biliary systems.

Pancreatectomy

If tumors occur throughout your pancreas, your surgeon may perform a total pancreatectomy, or the surgical removal of your entire pancreas. Your surgeon will check nearby organs and tissues for cancerous cells. If cancer is found, your surgeon will remove those as well.

Special Note Regarding Pancreatectomies

Surgery to remove all or part of your pancreas is a major surgical operation. You will stay in the hospital a week or more and need a month or more of recovery at home.

As with all operations, there are some risks. With pancreatectomies, you may have some additional side effects, including:

  • Difficulty digesting food
  • Feeling bloated or full
  • Nausea and vomiting
  • Diabetes from lack of insulin
  • Infections
  • Bleeding

Your dietitian on your Integrated Care Team will be key in helping you adjust your diet and returning to feeling normal again.

Splenectomy

If tumors occur in your spleen, your surgeon will remove all or part of your spleen in a surgical procedure called a splenectomy.

Gastrectomy

If tumors occur in your stomach, your surgeon will remove all or part of your stomach in a surgical procedure called a gastrectomy.

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