Home parenteral nutrition for people with inoperable malignant bowel obstruction

Sowerbutts, Anne Marie; Lal, Simon; Sremanakova, Jana; Todd, Chris; Jayson, Gordon C.; Teubner, Antje; Raftery, Anne-Marie; Sutton, Eileen; Hardy, Lisa; Burden, Sorrel

doi:10.1002/14651858.cd012812.pub2

Cited by 54 publications

(53 citation statements)

References 71 publications

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“…A formal Cochrane review of the use of home PN in individuals with inoperable MBO found that the benefits of PN are uncertain. Among 13 observational studies, mean survival ranged from 3 to 1278 days, and adverse effects of therapy occurred in 12% of patients 53 …”

Section: Principles Of Nutrition Support In Mbomentioning

confidence: 99%

The Chicago Consensus on peritoneal surface malignancies: Palliative care considerations

Plana¹,

Izquierdo²,

Schuitevoerder³

et al. 2020

Cancer

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The Chicago Consensus Working Group provides multidisciplinary recommendations for palliative care specifically related to peritoneal surface malignancies. These guidelines are developed with input from leading experts including surgical oncologists, medical oncologists, gynecologic oncologists, pathologists, radiologists, palliative care physicians, and pharmacists. These guidelines recognize and address the emerging need for increased awareness in the appropriate management of peritoneal surface disease. They are not intended to replace the quest for higher levels of evidence. Cancer 2020;126:2571-2576.Octreotide is a synthetic peptide mimicking the natural effects of somatostatin, thereby reducing gastrointestinal secretions and gastrointestinal motility. In multiple studies, octreotide has been demonstrated to reduce vomiting episodes and gastrointestinal symptoms. 17,18 In addition, quality-of-life scores have improved with the use of octreotide in nonrandomized clinical studies. 19,20 When compared with anticholinergic therapies,

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Section: Principles Of Nutrition Support In Mbomentioning

confidence: 99%

The Chicago Consensus on peritoneal surface malignancies: Palliative care considerations

Plana¹,

Izquierdo²,

Schuitevoerder³

et al. 2020

Cancer

View full text Add to dashboard Cite

show abstract

“…In a systematic review evaluating 437 patients, median overall survival was only 15 to 155 days. 80,81 If adjunctive nutrition is being considered for a patient with MBO, then it is important to stratify patients based on baseline performance status. In a study of 81 patients with MBO receiving parenteral nutrition, patients with a higher performance status (i.e., Karnofsky Performance Status [KPS] Score > 50) were found to have a median survival of 183 days compared with patients with a lower performance status (KPS 50) who were found to have a median survival of 91 days (p ¼ 0.01).…”

Section: Role Of Nutritional Supportmentioning

confidence: 99%

Malignant Gastrointestinal Obstruction: Options for Decompression and Nutrition

Litwin

Chan

Huang

2020

Digestive Disease Interventions

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Malignant bowel obstruction (MBO) is a relatively common condition affecting patients with advanced malignancy. Therapeutic interventions should be aimed at maintaining quality of life. Given the lack of prospective controlled studies in this patient population, patient management is often based on local practice patterns and anecdotal experience. To foster a collaborative approach among the members of the patient care team involving internal medicine, oncology, palliative care, clinical nutrition, surgery, gastroenterology, and interventional radiology physicians, it is important to improve our understanding of MBO. The purpose of this article is to describe the clinical presentation, pathophysiology, as well as medical, surgical, and nonsurgical palliative options available to patients with MBO for purposes of decompression and nutrition.

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“…While oral water‐soluble contrast may have benefit in the benign setting, there is no evidence that it is of benefit with an MBO . Total parenteral nutrition is controversial and there is no evidence for improved survival or quality of life . Palliative pharmacologic therapies have the goals of reducing intestinal inflammation and edema, and controlling pain, nausea, vomiting, and dehydration.…”

Section: Clinical Optionsmentioning

confidence: 99%

Malignant bowel obstruction

Krouse

2019

Journal of Surgical Oncology

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Malignant bowel obstruction (MBO) is a common problem for patients with advanced malignancy, especially colorectal and ovarian cancers. Symptoms include pain, bloating, nausea and vomiting, and inability to eat. Treatment options consist of a wide range of surgical and nonsurgical interventions (medications, endoscopic, or interventional radiology approaches). Outcomes are variable no matter the strategy, and the optimal approach is often not clear. Greater research is needed to assist decision-making for clinicians treating patients with MBO. K E Y W O R D S bowel, malignant, nonsurgery, obstruction, surgery How to cite this article: Krouse RS. Malignant bowel obstruction.

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Home parenteral nutrition for people with inoperable malignant bowel obstruction

Abstract: We are very uncertain whether HPN improves survival or quality of life in people with MBO as the certainty of evidence was very low for both outcomes. As the evidence base is limited and at high risk of bias, further higher-quality prospective studies are required.

Cited by 54 publications

References 71 publications

The Chicago Consensus on peritoneal surface malignancies: Palliative care considerations

The Chicago Consensus on peritoneal surface malignancies: Palliative care considerations

Malignant Gastrointestinal Obstruction: Options for Decompression and Nutrition

Malignant bowel obstruction

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