Results of surgery for malignant bowel obstruction in advanced, unresectable, recurrent colorectal cancer

Published on Jan 1, 1993in Diseases of The Colon & Rectum4.785
路 DOI :10.1007/BF02050303
Peter W. K. Lau8
Estimated H-index: 8
(HKU: University of Hong Kong),
Theo G. Lorentz6
Estimated H-index: 6
(HKU: University of Hong Kong)
Sources
Abstract
When conservative treatment fails in the management of patients with malignant bowel obstruction secondary to advanced, recurrent colorectal cancer, the attitude toward surgery is often less than enthusiastic because of the limited life expectancy. We report a retrospective review of 30 patients with unresectable intra-abdominal disease who underwent laparotomy for the relief of bowel obstruction. Normal bowel function was restored in 19 patients (63 percent). The failures included five patients (17 percent) who died as a result of surgical complications and six patients (20 percent) who despite the surgery had continuing obstruction. Postoperative complications occurred in eight patients (27 percent). The median survival was significantly improved in those who benefited from the operation (192 daysvs.26 days;P= 0.0001). Whether the obstruction occurred at one site or more than one site appeared not to influence the outcome of surgery. Obstruction recurred after a mean symptomfree interval of 120 days in eight of those relieved by the initial operation. Half of these patients responded to conservative treatment, and surgery was again beneficial in three of the remaining four. Our results justify a more positive approach toward this problem, and, when conservatism fails, laparotomy should be undertaken in those who are not terminally ill.
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Results of operation for obstructing carcinomatosis of gastrointestinal (GI), pancreatic, or biliary origin were reviewed to assess relief of symptoms, management of re-obstruction, and duration of hospitalization. A retrospective review (1977 to 1986) identified 89 patients, 59 (66%) of whom had tumors originating in the colon, and 19 (21%) in the stomach. Normal bowel function was restored for a median of 102 days in 66 patients (74%) and all but four (94%) were discharged. Forty-one (46%) pat...
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Summary Operative therapy is beneficial in patients with bowel obstruction after operation for colorectal carcinoma. The cause of the bowel obstruction is more likely to be benign following colorectal carcinoma than following other malignancies. Also, the period of preoperative nasogastric suction can safely be extended to 3 to 4 days in these patients, since a resolution rate of 28 percent can be achieved with minimal risk of strangulation.
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Abstract A clinical and pathological study was made of 40 patients with intestinal obstruction due to far-advanced abdominal and/or pelvic malignant disease. Surgical intervention was feasible in only 2 cases. The remaining 38 patients were managed medically without intravenous fluids and nasogastric suction. Obstructive symptoms such as intestinal colic, vomiting, and diarrhoea were effectively controlled by drugs.
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: The records of 66 consecutive patients who developed intestinal obstructions after treatment for cancer were reviewed. Approximately one third of the patients were found to have a benign cause of obstruction. The chances that an obstruction was due to cancer were increased if the patient had known metastatic cancer, previous colorectal cancer, if the primary was an advanced stage, and if the interval since treatment of the primary was short. Incomplete obstructions were treated with nasogastri...
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#2Robert C. Hoye (NIH: National Institutes of Health)H-Index: 23
Last. Donald L. Morton (NIH: National Institutes of Health)H-Index: 21
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A review of 117 patients who have been treated for cancer and subsequently developed 173 episodes of intestinal obstruction has established guidelines for the management of the cancer patient with abdominal distress. Operative intervention is the treatment of choice for intestinal obstruction occurring in a patient previously treated for a malignant neoplasm. Approximately one fourth of such patients will have intestinal obstructions which are not caused by recurrence of, or metastases from, the...
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Abstract Background Several authors have reported on the utility of a laparoscopic approach for the palliation of malignant bowel obstruction (MBO); however, the advantages of laparoscopic surgery for MBO have not yet been confirmed. Methods We retrospectively reviewed the medical records of patients who underwent palliative surgery for MBO between 2007 and 2015. Laparoscopic procedures have been performed when technically possible since 2014. Successful palliation was defined as the ability to ...
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#1Sarah E Cousins (Barts Health NHS Trust)H-Index: 1
#2Emma TempestH-Index: 1
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#1Terrah J. Paul Olson (UW: University of Wisconsin-Madison)H-Index: 6
#2Carolyn Pinkerton (MCW: Medical College of Wisconsin)H-Index: 1
Last. Margaret L. Schwarze (UW: University of Wisconsin-Madison)H-Index: 20
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