scholarly journals Drainage Percutaneous Endoscopic Gastrostomy for Malignant Bowel Obstruction in Gastrointestinal Cancers: Prognosis and Implications for Timing of Palliative Intervention

2017 ◽  
Vol 20 (7) ◽  
pp. 774-778 ◽  
Author(s):  
Kerry-Ann Pinard ◽  
Tabitha N. Goring ◽  
Barbara C. Egan ◽  
Douglas J. Koo
Keyword(s):  
Bowel Obstruction ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Malignant Bowel Obstruction ◽  
Gastrointestinal Cancers ◽  
Endoscopic Gastrostomy

scholarly journals Illness Understanding, Prognostic Awareness, and End-of-Life Care in Patients With GI Cancer and Malignant Bowel Obstruction With Drainage Percutaneous Endoscopic Gastrostomy

2020 ◽  
pp. OP.20.00035
Author(s):  
Jessica I. Goldberg ◽  
Debra A. Goldman ◽  
Sarah McCaskey ◽  
Douglas J. Koo ◽  
Andrew S. Epstein
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Bowel Obstruction ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Malignant Bowel Obstruction ◽  
Do Not Resuscitate ◽  
Future Expectations ◽  
Endoscopic Gastrostomy ◽  
Gi Cancer ◽  
Additional Chemotherapy

PURPOSE: Malignant bowel obstruction (MBO) is common in advanced GI cancer, and MBO management, including drainage percutaneous endoscopic gastrostomy (dPEG), is palliative. How patients understand the goals of dPEG and its impact on disease is inadequately understood in the literature. Therefore, we analyzed these issues in patients with GI cancer. METHODS: Demographics, clinical variables, and patient outcomes were abstracted from the medical record. Illness understanding and future expectations were retrieved from palliative care notes. We described additional treatment and outcomes after dPEG and estimated overall survival (OS). RESULTS: From January 2015 to June 2017, 125 admitted patients with metastatic GI cancer underwent dPEG for MBO. Cancers were most commonly colorectal (34%) and pancreatic/ampullary (25%). During the dPEG admission, 32% (40 of 125) of patients had a palliative care consultation, and 22% (28 of 125) were asked about illness understanding and future expectations. All (28 of 28) reported good understanding of the advanced nature of their disease, but few were accurate about prognosis given their stage IV disease (10 of 28). Of the 117 (94%) discharged, 13% (15 of 117) received additional chemotherapy, which rarely prevented progression; half (63 of 117) had a do-not-resuscitate order; and most (101 of 117) were enrolled in hospice at death. Median time to death was 37 days (95% CI, 29 to 45 days); 6-month OS was 3.7% (95% CI, 1.2% to 8.4%). CONCLUSION: dPEGs are placed close to end of life in patients with advanced GI cancer. A minority of patients receive additional chemotherapy post-dPEG. Many have adequate disease understanding, but chemotherapy benefit is low, and future expectations vary. This may be an opportunity for improved communication regarding palliative procedures in advanced cancer.

Percutaneous endoscopic gastrostomy for decompression of malignant bowel obstruction

2013 ◽  
Vol 26 (2) ◽  
pp. 208-213 ◽  
Author(s):  
Noboru Kawata ◽  
Naomi Kakushima ◽  
Masaki Tanaka ◽  
Hiroaki Sawai ◽  
Kenichiro Imai ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Malignant Bowel Obstruction ◽  
Endoscopic Gastrostomy

Who Goes Home after Palliation? Utilization of Venting Percutaneous Endoscopic Gastrostomy in Malignant Bowel Obstruction

2016 ◽  
Vol 223 (4) ◽  
pp. S49-S50
Author(s):  
Christy E. Cauley ◽  
Elizabeth J. Lilley ◽  
Joel Weissman ◽  
Angela M. Bader ◽  
David L. Hepner ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Malignant Bowel Obstruction ◽  
Endoscopic Gastrostomy

Malignant Bowel Obstruction

2011 ◽  
Vol 28 (8) ◽  
pp. 576-582 ◽  
Author(s):  
Elisabeth A. Dolan
Keyword(s):  
Bowel Obstruction ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Surgical Procedures ◽  
Symptom Management ◽  
Performance Status ◽  
Malignant Bowel Obstruction ◽  
Medical Interventions ◽  
Less Invasive ◽  
Endoscopic Gastrostomy ◽  
Pelvic Malignancies

Malignant bowel obstruction is common in individuals with intra-abdominal and pelvic malignancies and results in considerable suffering. Treatments target both the resolution of obstruction and symptom management. Emerging procedures include stents placement in the bowel to return patency and newer surgical procedures that are evolving to be less invasive. The use of medical interventions like corticosteroids, alone or in concert with additional drugs, can be utilized to achieve resolution of obstruction. Throughout treatment, it is important to also aggressively treat obstructive symptoms like pain and nausea/vomiting. This can mostly be achieved with medications, but use of venting percutaneous endoscopic gastrostomy (PEG) can also relieve symptoms. Parenteral hydration and nutrition use remain controversial with this population. The factor most closely tied to prognosis is performance status.

scholarly journals Large-Bowel Obstruction: A Complication of Percutaneous Endoscopic Gastrostomy

Endoscopy ◽  
1996 ◽  
Vol 28 (08) ◽  
pp. 728-728 ◽  
Author(s):  
S. P. Mönig ◽  
H. Schäfer ◽  
M. Walter ◽  
K. E. Rehm
Keyword(s):  
Bowel Obstruction ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Large Bowel ◽  
Large Bowel Obstruction ◽  
Endoscopic Gastrostomy
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