scholarly journals Outcomes and Prognostic Factors in Patients who Underwent Palliative Surgery for Malignant Bowel Obstruction due to Peritoneal Dissemination

2020 ◽  
Vol 81 (6) ◽  
pp. 1029-1035
Author(s):  
Naruyuki KOBAYASHI ◽  
Takaya KOBATAKE ◽  
Ryoji OCHIAI ◽  
Kazuma IWATA ◽  
Manato OHSAWA ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Bowel Obstruction ◽  
Peritoneal Dissemination ◽  
Palliative Surgery ◽  
Malignant Bowel Obstruction

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

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. 

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.

Multicenter prospective observational study of QoL after palliative surgery for patients with bowel obstruction caused by peritoneal dissemination of gastric cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 90-90
Author(s):  
Yuichi Ito ◽  
Kazumasa Fujitani ◽  
Kentaro Sakamaki ◽  
Masahiko Ando ◽  
Ryohei Kawabata ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Small Intestine ◽  
Mortality Rate ◽  
Bowel Obstruction ◽  
Peritoneal Dissemination ◽  
Oral Intake ◽  
Palliative Surgery ◽  
Poor Oral Intake

90 Background: Patients with peritoneal dissemination of gastric cancer have poor oral intake caused by bowel obstruction. Palliative surgery has often been undertaken to improve quality of life (QoL), but there is no prospective study on palliative surgery. Methods: We prospectively examined the significance of palliative surgery for patients with poor oral intake caused by peritoneal dissemination of gastric cancer using a patient-reported QoL measures. Eligibility criteria included histologically proven primary gastric adenocarcinoma presenting with bowel obstruction caused by peritoneal dissemination; presence of non-curable factors; extremely poor or no oral intake requiring parenteral nutrition. Patients underwent palliative surgery by small intestine/colon resection, small intestine/colon bypass or ileostomy/colostomy for bowel obstruction. The primary endpoint was change in QoL assessed at baseline, 14 days, 1 month and 3 months following surgical palliation by means of the Euro QoL Five Dimensions (EQ-5D) questionnaire and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire gastric cancer module (QLQ-STO22). Secondary endpoints were postoperative improvement in oral intake and surgical complications. Results: Between May 2013 and March 2018, 63 patients (33 bypass and 28 stoma, 3 exploratory laparotomy) were enrolled from 14 institutions. The mean EQ-5D utility index baseline score of 0.6 remained consistent. Gastric-specific symptoms mostly showed statistically significant improvement from baseline. 42 patients (67%) were able to eat solid food 2 weeks after palliative surgery and 36 patients (57%) tolerated it for 3 months. The rate of overall morbidity of grade III or more according to the Clavien–Dindo classification was 15.8 per cent (10 patients) and the 30-day postoperative mortality rate was 3.2 per cent (2 patients). Conclusions: In patients with bowel obstruction caused by peritoneal dissemination of gastric cancer, palliative surgery maintained QoL while improving solid food intake, with acceptable operative morbidity and mortality rate. Clinical trial information: 000023495.

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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