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MALIGNANT SMALL BOWEL OBSTRUCTION: OUTCOMES OF PALLIATIVE SURGERY

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Surgical management of malignant bowel obstruction (MBO) represents a surgical challenge associated with high morbidity and mortality, readmission and re-obstruction rates. The aim of this study is to describe the… Click to show full abstract

Surgical management of malignant bowel obstruction (MBO) represents a surgical challenge associated with high morbidity and mortality, readmission and re-obstruction rates. The aim of this study is to describe the postoperative outcomes of palliative surgery for MBO in order to provide a guide for oncologists, surgeons and patients. Retrospective descriptive study in a tertiary referral centre of all the patients operated of an acute bowel obstruction or bowel perforation due to peritoneal carcinomatosis between January 2015 and December 2019. Fifty-one patients were included in the study. Time from index surgery to clinical recurrence as MBO was 21±27 months. The indication for surgery was acute obstruction in 92.2% and bowel perforation in 7.8% of the patients. Intraoperative complications were found in 24% of the patients. Postoperative complications were found in 71% of the patients. Postoperative mortality was 16%. Length of stay was 31±26 days with a median postoperative stay of 20±16 days. Time to reobstruction in the whole series was 216±240 days. 90-day mortality was 31%. The median overall survival of patients that survived the first 90 postoperative days was 286.45±281.14 days (9.5 months). Most of the patients who survived the 90-postoperative days received systemic treatment (66%). Palliative surgery for MBO is associated with high rates of postoperative complications and mortality. Well-selected patients that survive the first 90 postoperative days may have a long symptom-free period and longer survival.

Keywords: outcomes palliative; bowel obstruction; bowel; surgery; palliative surgery

Journal Title: British Journal of Surgery
Year Published: 2021

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