Outcomes of emergency surgical treatment in malignant bowel obstructions

Malignant bowel obstructions are still a challenging problem for surgeons and carry high morbidity and mortality risk. The aim of this study was to review the presentation and outcomes of malignant bowel obstructions and to identify the risk factors related with poor prognosis.

One hundred and twenty-five patients underwent emergency surgical treatment for malignant obstructions between January 1997 and January 2002. Data included age, sex, past medical history, presenting symptoms; physical findings on admission, American Society of Anesthesiologists (ASA) class, operative details, postoperative complications, length of hospitalization and hospital mortality were reviewed retrospectively.

Seventy-three (58%) of the patients have poor performance status on admission. Potentially curative resection was performed in 74 (60%) patients. Surgical treatment was palliative in 43 (34%) patients. Extended bowel resections were utilized in 20 (16%) patients. Our hospital mortality rate was 21%, and postoperative morbidity rate was 31%. Coexisting cardiopulmonary diseases, presence of generalized perforation, poor general condition and extended bowel resections appeared to be related with unfavorable outcomes.

Emergency surgical treatment for malignant obstruction may be curative in selected patients with good performance status.