Malignant bowel obstruction

Krouse, Robert S.

doi:10.1002/jso.25451

Cited by 43 publications

(46 citation statements)

References 34 publications

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“…The quality of life for patients with MSBO post-surgery is largely unstudied and when it has been studied, the tools used are unvalidated. 7 A 2016 Cochrane review of MSBO identified no data on quality-of-life scores. 4 The ability of patients to tolerate oral intake after surgery, time spent out of the hospital, and discharge to home have all been used as surrogate quality-of-life metrics.…”

Section: Discussionmentioning

confidence: 99%

“…With multiple different therapeutic options for management of MSBO, including endoscopic, medical, surgical, and palliative care approaches, determining which patients would benefit most from surgery is critical. 7 Certain clinical factors, such as dependent functional status, older age, presence of ascites, and preoperative nutritional status are associated with poorer surgical outcomes and can therefore be used to help guide decision-making. 4 8 9 The effects of other clinical factors on surgical outcomes, such as the type of malignancy, extent of metastatic disease, and patient response to systemic treatment, are less well studied.…”

Section: Introductionmentioning

confidence: 99%

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Current management of malignant bowel obstructions: a survey of acute care surgeons and surgical oncologists

Bleicher

Lambert

Scaife

et al. 2021

Trauma Surg Acute Care Open

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BackgroundMalignant small bowel obstructions (MSBOs) are one of the most challenging problems surgeons encounter, and evidence-based treatment recommendations are lacking. We hypothesized that current opinions on MSBO management differ between acute care surgeons (ACSs) and surgical oncologists (SOs).MethodsWe developed three case scenarios describing patients with previously treated cancer who developed an MSBO. Each case had five to six alternate scenarios, intended to capture the heterogeneity of MSBO presentations. Members of the Society of Surgical Oncology, the American Society of Peritoneal Surface Malignancies, and the Eastern Association for the Surgery of Trauma were asked how likely they would be to offer surgical treatment in each scenario. Responses were analyzed for factors associated with the likelihood surgeons would offer surgical management.Results316 surgeons completed the survey: 119 (37.7%) SOs and 197 (62.3%) ACSs. Overall, SOs were nearly twice as likely as ACSs to recommend surgical management. The largest differences between provider groups were seen in patients with an increased metastatic burden. In a patient with MSBO with metastatic colon cancer, both SOs (95.8%) and ACSs (94.4%) were likely or very likely to offer an operation (p=0.587); however, this fell to 91.6% and 77.7%, respectively, when this patient had multiple hepatic metastases (p=0.001). All surgeons were less likely to offer surgery to patients with multiple sites of obstruction, recurrent MSBO, and shorter disease-free intervals.DiscussionOpinions on MSBO management differ based on surgeon training and experience. Multidisciplinary management of patients with MSBO should be offered when available and increased emphasis placed on determining optimal management guidelines across specialties.Level of evidenceLevel IV Epidemiologic.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Current management of malignant bowel obstructions: a survey of acute care surgeons and surgical oncologists

Bleicher

Lambert

Scaife

et al. 2021

Trauma Surg Acute Care Open

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“…A su vez, en el 80 % de los pacientes con cáncer avanzado, la OGIM puede presentar múltiples niveles de obstrucción en relación con un diagnóstico previo de carcinomatosis peritoneal. Por otra parte, puede ser secundaria a su tratamiento, como sucede en la formación de fibrosis o enteritis por radiación, etiología benigna como bridas hasta en un 20 %, e indeterminada en un 12 % (6)(7)(8).…”

Section: Introductionunclassified

Gastrostomía descompresiva en obstrucción gastrointestinal maligna: reporte de caso y revisión de la literatura

Morros-González

Vargas

Ovalle

2021

Rev colomb Gastroenterol

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La gastrostomía descompresiva durante los últimos años ha surgido como una alternativa de manejo para la paliación de síntomas en personas con enfermedad oncológica terminal que desarrollan obstrucción intestinal sin indicación quirúrgica inicial y es refractaria al manejo médico. El objetivo es brindar calidad de vida a través de la restauración de la vía oral. Sus contraindicaciones han variado con el tiempo; sin embargo, han surgido nuevas técnicas que permiten ampliar el espectro de indicaciones de este procedimiento. Se ha descrito que permite apoyar el control de síntomas, el retorno de la persona a su lugar de cuidado y, posiblemente, el reinicio de la vía oral con la intención de mantener la calidad de vida de la persona.

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“…1 Although the exact definition of MBO varies, one generally accepted version constitutes clinical symptoms of bowel obstruction concomitant with evidence of primary or secondary intra-abdominal cancer. 2 MBO may occur as a result of cancer advancement (eg, tumor over-growth), anti-cancer treatment (eg, radiation scarring), or other benign factors (eg, adhesive blockade). In later stages, the obstructed intestinal segments may impede the passage of intraluminal contents, resulting in imbalance of electrolyte or even mesenteric ischemia.…”

Section: Introductionmentioning

confidence: 99%

<p>Surgical and Conservative Management of Malignant Bowel Obstruction: Outcome and Prognostic Factors</p>

Yu¹,

Liu²,

Zhang³

et al. 2020

CMAR

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Malignant bowel obstruction (MBO) is a common problem in late-stage cancer patients. Many factors are suggested to be associated with the prognosis of MBO. The current investigation was designed to explore the factors associated with the prognosis of conservative and surgery treatment in one single institution. Patients and Methods: Sixty-four patients of MBO were recruited into the study. Demographic and clinical data including gender, age, primary cancer, radiological and laboratory examinations, and nutritional and pain index scaling were extracted for further analysis. Kaplan-Meier analysis and logistic regression analysis were used to compare the prognosis and detect significant factors. Results: Of the 64 patients, there is no statistical difference in baseline features between conservative and surgical group. However, the length of stay, total medical costs, readmission interval, and re-admission rate are statistically significant. There is no significance in Kaplan-Meier log rank test for median survival time, though the overall survival time in the conservative group is longer than that of the surgery group. Logistic regression analysis has found that prior chemotherapy is a significant predictor for final survival outcome. Conclusion: The election of surgery might not improve the overall survival time. Nonsurgical procedures, especially chemotherapy, might be preferable for MBO patients.

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Malignant bowel obstruction

Cited by 43 publications

References 34 publications

Current management of malignant bowel obstructions: a survey of acute care surgeons and surgical oncologists

Current management of malignant bowel obstructions: a survey of acute care surgeons and surgical oncologists

Gastrostomía descompresiva en obstrucción gastrointestinal maligna: reporte de caso y revisión de la literatura

<p>Surgical and Conservative Management of Malignant Bowel Obstruction: Outcome and Prognostic Factors</p>

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