scholarly journals The Role of Palliative Surgery for Malignant Bowel Obstruction and Perforation in Advanced Microsatellite Instability-High Colorectal Carcinoma in the Era of Immunotherapy: Case Report

2020 ◽  
Vol 10 ◽  
Author(s):  
Sean J. Judge ◽  
Jingran Ji ◽  
James Liu ◽  
Manmeet Kaur ◽  
Edward Kim ◽  
...  
Keyword(s):  
Case Report ◽  
Colorectal Carcinoma ◽  
Microsatellite Instability ◽  
Bowel Obstruction ◽  
Palliative Surgery ◽  
Malignant Bowel Obstruction

scholarly journals Prognostic Factors for Surgical Failure in Malignant Bowel Obstruction and Peritoneal Carcinomatosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Claudio Lodoli ◽  
Marcello Covino ◽  
Miriam Attalla El Halabieh ◽  
Francesco Santullo ◽  
Andrea Di Giorgio ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Characteristic Curve ◽  
Prognostic Score ◽  
Palliative Surgery ◽  
Malignant Bowel Obstruction ◽  
Bowel Distension ◽  
Surgical Interventions ◽  
Patients At Risk ◽  
Surgical Failure

Introduction: Patients with peritoneal metastasis frequently develop malignant bowel obstruction (MBO). Medical palliative management is preferred but often fails. Conversely, the role of palliative surgery remains unclear and debated. This study aims to identify patients who could benefit from invasive surgical interventions and factors associated with successful surgical palliation.Materials and Methods: In this retrospective study, 98 consecutive patients who underwent palliative surgery for MBO over 5 years were reviewed. We evaluate as the primary outcome surgical failure to select patients who could benefit from palliative surgery, avoiding unnecessary surgery. A prognostic score was developed based on a logistic regression model to identify patients at risk of surgical failure. The score was evaluated for overall accuracy by receiver operating characteristic curve analysis.Results: Palliative surgery was achieved in 76 (77.5%) patients. The variables that were found to be significant factors for surgical failure are recurrent disease (P = 0.015), absence of bowel obstruction (P < 0.001), absence of bowel distension (P < 0.001), and mesenteric involvement (P = 0.001) and retraction (P < 0.001). The absence of bowel distension (P = 0.046) and bowel obstruction (P = 0.012) emerged as independent predictors of surgical failure. Carcinomatosis level assessment for peritoneum score, based on these factors, was built to evaluate the risk of surgical failure.Conclusion: Our proposed scoring system might help select patients most likely to benefit from palliative surgery.

Octreotide for Malignant Bowel Obstruction (DRAFT)

2018 ◽  
Author(s):  
Shalini Dalal
Keyword(s):  
Prospective Study ◽  
Bowel Obstruction ◽  
Clinical Case ◽  
Malignant Bowel Obstruction ◽  
Advanced Cancer Patients ◽  
Symptomatic Management ◽  
A Prospective Study ◽  
Study Intervention

This chapter describes a prospective study published in 2002 evaluating the role of octreotide in the symptomatic management of advanced cancer patients with bowel obstruction that cannot be treated surgically. The chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case. Topics covered include octreotide, bowel obstruction, vomiting, and abdominal distention.

scholarly journals A laparoscopic approach is associated with a decreased incidence of SSI in patients undergoing palliative surgery for malignant bowel obstruction

2017 ◽  
Vol 42 ◽  
pp. 90-94
Author(s):  
Yoshiaki Maeda ◽  
Toshiki Shinohara ◽  
Tomonari Katayama ◽  
Nozomi Minagawa ◽  
Masao Sunahara ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Laparoscopic Approach ◽  
Palliative Surgery ◽  
Malignant Bowel Obstruction

scholarly journals EP.FRI.468 A review of the management of malignant bowel obstruction at an NHS teaching hospital

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Jessica Banks ◽  
Sony Aiynattu ◽  
Rafik Ishak
Keyword(s):  
Palliative Care ◽  
Length Of Stay ◽  
Bowel Obstruction ◽  
Peritoneal Metastasis ◽  
Palliative Surgery ◽  
Malignant Bowel Obstruction ◽  
Readmission Rates ◽  
Mortality And Morbidity ◽  
Clinical Dilemma ◽  
Complications And Mortality

Abstract Patients presenting with malignant bowel obstruction (MBO) due to peritoneal metastasis present a clinical dilemma for surgeons: although palliative surgery is beneficial, post-operative complications and mortality are as high as 30%.  A personalised and multi-disciplinary approach is paramount when treating these patients. Aims This study aimed to review the management (surgical versus conservative) of patients presenting with MBO; ascertain if a multi-disciplinary approach was adopted; and compare clinical outcomes including length-of-stay, readmission rates and mortality.  Methods All patients admitted with MBO secondary to peritoneal metastasis between January 2019 – January 2021 were identified. Results 29 patients; 14 females, were identified with a median age 72. The median length of stay was 16 days. All patients had a CT scan and 76% were performed within 24 hours of admission. 25/29 patients were referred to palliative care. Conclusions Overall mortality and morbidity in our cohort, regardless of surgical or conservative management, is consistent with existing literature. Palliative care input was sought for the majority of patients. Management decisions should be individualised and focus on ensuring the best quality of life for the patient. All decisions should be made with multi-disciplinary input. 

Mo1700 Palliative Surgery for Malignant Bowel Obstruction: A Systematic Review

2013 ◽  
Vol 144 (5) ◽  
pp. S-1094
Author(s):  
Terrah J. Paul Olson ◽  
Carolyn Pinkerton ◽  
Karen J. Brasel ◽  
Margaret L. Schwarze
Keyword(s):  
Systematic Review ◽  
Bowel Obstruction ◽  
Palliative Surgery ◽  
Malignant Bowel Obstruction
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