scholarly journals Surgical and Conservative Management of Malignant Bowel Obstruction: Outcome and Prognostic Factors

2020 ◽  
Vol Volume 12 ◽  
pp. 7797-7803
Author(s):  
Kaiying Yu ◽  
Lihui Liu ◽  
Xiaowei Zhang ◽  
Zhanzhi Zhang ◽  
Benqiang Rao ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Bowel Obstruction ◽  
Conservative Management ◽  
Malignant Bowel Obstruction

Outcome prognostic factors in inoperable malignant bowel obstruction

2016 ◽  
Vol 24 (11) ◽  
pp. 4577-4586 ◽  
Author(s):  
Margarita Romeo ◽  
Maria de los LLanos Gil ◽  
José Luís Cuadra Urteaga ◽  
Laia Vilà ◽  
Sara Ahlal ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Bowel Obstruction ◽  
Malignant Bowel Obstruction

Factors impacting length of stay and survival in patients with advanced gynecologic malignancies and malignant bowel obstruction

2021 ◽  
pp. ijgc-2020-002133
Author(s):  
Melissa Tigert ◽  
Christine Lau ◽  
Helen Mackay ◽  
Stephanie L'Heureux ◽  
Lilian T. Gien
Keyword(s):  
Overall Survival ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Bowel Obstruction ◽  
Conservative Management ◽  
Tertiary Care ◽  
Gynecologic Cancer ◽  
Length Of Hospital Stay ◽  
Malignant Bowel Obstruction ◽  
Gynecologic Malignancies

ObjectivesMalignant bowel obstruction in patients with gynecologic malignancies can impose a large symptomatic burden. The objectives of this study were to identify factors associated with shorter length of hospital stay and overall survival in gynecologic oncology patients with malignant bowel obstructions.MethodsA retrospective chart review was performed from December 2014 to March 2019 on patients admitted to a tertiary care center with a malignant bowel obstruction and advanced gynecologic malignancy. Data collection included patient and tumor characteristics, malignant bowel obstruction management (such as conservative management with bowel rest, nasogastric tube, pharmacotherapy or active intervention with surgery, chemotherapy, radiation, total parenteral nutrition or interventional stents), length of hospital stay, and survival outcomes. Statistical analysis included comparisons with Student’s t-test and χ2 test, multivariable analysis, and survival analysis.ResultsA total of 107 patients with gynecologic cancer with malignant bowel obstruction were included. The majority of patients (63%, n=67) had ovarian cancer. The median length of hospital stay was 12 days (range 1–23), with a median overall survival after malignant bowel obstruction diagnosis of 7 months (range 0.1–64.1). Patients with active interventions had a longer length of stay compared with those with conservative management (13 vs 6 days, p<0.001). However, patients who received multiple active interventions had increased overall survival (9.1 vs 2.9 months, p=0.049).ConclusionPatients who received multimodal treatment for malignant bowel obstruction had an increased length of stay and improvement in survival of over 6 months. This emphasizes the importance of a multidisciplinary approach to actively manage malignant bowel obstruction in advanced gynecologic cancer.

scholarly journals Adhesive Small Bowel Obstruction and the six w’s: Who, How, Why, When, What, and Where to diagnose and operate?

2021 ◽  
pp. 145749692098276
Author(s):  
M. Podda ◽  
M. Khan ◽  
S. Di Saverio
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Conservative Management ◽  
Bowel Ischemia ◽  
Current Evidence ◽  
First Episode ◽  
Adhesive Small Bowel Obstruction ◽  
Highly Effective

Background and Aims: Approximately 75% of patients admitted with small bowel obstruction have intra-abdominal adhesions as their cause (adhesive small bowel obstruction). Up to 70% of adhesive small bowel obstruction cases, in the absence of strangulation and bowel ischemia, can be successfully treated with conservative management. However, emerging evidence shows that surgery performed early during the first episode of adhesive small bowel obstruction is highly effective. The objective of this narrative review is to summarize the current evidence on adhesive small bowel obstruction management strategies. Materials and Methods: A review of the literature published over the last 20 years was performed to assess Who, hoW, Why, When, What, and Where diagnose and operate on patients with adhesive small bowel obstruction. Results: Adequate patient selection through physical examination and computed tomography is the key factor of the entire management strategy, as failure to detect patients with strangulated adhesive small bowel obstruction and bowel ischemia is associated with significant morbidity and mortality. The indication for surgical exploration is usually defined as a failure to pass contrast into the ascending colon within 8–24 h. However, operative management with early adhesiolysis, defined as operative intervention on either the calendar day of admission or the calendar day after admission, has recently shown to be associated with an overall long-term survival benefit compared to conservative management. Regarding the surgical technique, laparoscopy should be used only in selected patients with an anticipated single obstructing band, and there should be a low threshold for conversion to an open procedure in cases of high risk of bowel injuries. Conclusion: Although most adhesive small bowel obstruction patients without suspicion of bowel strangulation or gangrene are currently managed nonoperatively, the long-term outcomes following this approach need to be analyzed in a more exhaustive way, as surgery performed early during the first episode of adhesive small bowel obstruction has shown to be highly effective, with a lower rate of recurrence.

Management of Patients with Malignant Bowel Obstruction and Stage IV Colorectal Cancer

2011 ◽  
Vol 14 (7) ◽  
pp. 822-828 ◽  
Author(s):  
Kimberly Moore Dalal ◽  
Marc J. Gollub ◽  
Thomas J. Miner ◽  
W. Douglas Wong ◽  
Hans Gerdes ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Bowel Obstruction ◽  
Stage Iv ◽  
Malignant Bowel Obstruction ◽  
Stage Iv Colorectal Cancer
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