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Small-bowel resection for metastatic melanoma
I F al-Sheneber1, S H Meterissian, A Loutfi
1Department of Surgery, Royal Victoria Hospital, McGill University, Montreal, Que.
Objective:
To determine whether complete resection of small-bowel metastases from melanoma improves patient survival.
Design:
A computer-aided chart review.
Setting:
Hospitals associated with McGill University.
Patients:
Twenty patients (17 men, 3 women), identified from 1524 patients with melanoma, who underwent surgery to the small bowel for metastases. Patient age and clinical presentation, tumour site and stage were recorded.
Intervention:
Exploratory laparotomy with complete or partial resection of involved small bowel.
Main Outcome Measures:
Operative morbidity, mortality and length of survival related to the extent of small-bowel resection.
Results:
Eleven patients had complete resection, 8 patients had partial resection and 1 patient had a palliative bypass only. Long-term survival (ranging from 2 to 10 years) was 36% in those who had complete resection and 0% in those who had partial resection; operative morbidity and mortality were 20% and 15% respectively.
Conclusion:
Complete resection of small-bowel metastases in patients with metastatic melanoma can result in long-term survival.