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ARTICLE |

Management of Bowel Obstruction in Patients With Abdominal Cancer

Richard G. Woolfson; Kim Jennings; Giles F. Whalen, MD
Arch Surg. 1997;132(10):1093-1097. doi:10.1001/archsurg.1997.01430340047006.
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Objective:  To determine the value of operation in patients with bowel obstruction caused by recurrent abdominal cancer.

Design:  Retrospective case review.

Setting:  The University of Connecticut Health Center, Farmington.

Patients:  Ninety-eight patients admitted with a diagnosis of bowel obstruction and malignant neoplasm between November 1, 1987, and June 30, 1995.

Results:  Data for 75 patients who developed a bowel obstruction within 5 years of a malignant diagnosis were analyzed. Forty-six patients (61%) were treated operatively and 29 (39%) were treated nonoperatively. The operative group included 32 patients (70%) whose obstruction was caused by carcinomatosis; 6 (19%) of these 32 patients had had at least 1 episode of previous obstruction requiring hospitalization. They had a 22% in-hospital mortality, stayed an average of 21 days in the hospital, and survived 7±6 months (mean±SD) after discharge; 5 (16%) had at least 1 episode of postoperative obstruction that required hospitalization. After discharge from the hospital, 53% had an excellent or good quality of life (assessed retrospectively). Of the 29 patients in the nonoperative group, 16 (55%) had carcinomatosis. These 16 patients had a 38% in-hospital mortality (6 of 16), stayed an average of 10 days in the hospital, and survived a mean of 13±9 months; 3 (19%) had at least 1 episode of recurrent obstruction requiring hospitalization. After discharge from the hospital, 6 (37%) had an excellent or good quality of life.

Conclusion:  The value of operative intervention for bowel obstruction in patients with cancer is derived from the possibility of a benign cause, not alleviation of the consequences of carcinomatosis.Arch Surg. 1997;132:1093-1097

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