Clinical Spectrum and Surgical Outcomes of Small Bowel Tumors: A Single‑Center Experience

Background Small bowel tumors are uncommon and often present with nonspecific symptoms or acute complications. As a result, diagnosis is often delayed, and operative decisions are often challenging. We assessed clinical presentations, operative approaches, histopathology, adjuvant therapy, and early outcomes relating to these tumors at a tertiary referral center. Methods We conducted a retrospective cohort study of consecutive adults who underwent resection of a suspected small‑bowel mass between January 2019 and December 2024 at Hamad Medical Corporation in Qatar. We abstracted the demographics, presentation (emergent or elective), operative approach, histopathology, adjuvant therapy, disease progression, and mortality from electronic records. The primary comparison contrasted emergent and elective presentations. The results are reported as N (%). Results Thirty‑one patients were included, of whom 25 (80.6%) were male. The patients had a mean age of 53.4 ± 14.2 years. The presentation was emergent in 21 of the patients (67.7%) and elective in 10 of the patients (32.3%). Laparoscopic resection was performed on 14 of the patients (45.2%) and open surgery on 17 patients (54.8%). Laparoscopy was more frequent in the elective cases (9 of the 10 cases, 90.0%) than in emergent cases (5 of the 21 cases, 23.8%). The most common pathologies were gastrointestinal stromal tumors (GISTs) in 13 of the 31 patients (41.9%), neuroendocrine tumors in 6 of the patients (19.4%), and adenocarcinomas in 4 of the patients (12.9%). Adjuvant therapy included imatinib in 9 of the 31 patients (29.0%), cytotoxic chemotherapy in 3 of the patients (9.7%), and octreotide in 2 of the patients (6.5%). Disease progression occurred in 6 of the 31 patients (19.4%) overall, including 5 of the 13 GIST patients (38.5%) and 1 of the 4 adenocarcinoma patients (25.0%). One of the 31 patients (3.2%) died. Conclusions The urgency of presentation strongly influenced the operative strategy. The well‑staged elective cases were frequently approached laparoscopically, whereas most of the emergent cases involved open surgery. Histology‑guided adjuvant therapy was commonly employed. These findings support the use of presentation‑aware pathways and multidisciplinary care to optimize early outcomes.