Current concepts in malignant bowel obstruction management
Eric Roeland1, Charles F von Gunten
1The Institute for Palliative Medicine at San Diego Hospice, 4311 Third Avenue, San Diego, CA 92103, USA. eroeland@sdhospice.org
Current Oncology Reports
|June 11, 2009
Summary
Malignant bowel obstruction (MBO) management involves surgery, stenting, or medical therapy. Most patients benefit from medical management for symptom control in advanced cancer.
Area of Science:
- Oncology
- Gastroenterology
- Palliative Care
Background:
- Malignant bowel obstruction (MBO) is a complex complication in advanced cancer patients.
- Pathophysiology involves mechanical compression, motility issues, secretion accumulation, and inflammation.
Purpose of the Study:
- To discuss the pathophysiology of MBO.
- To review current surgical, interventional, and medical management strategies for MBO.
Main Methods:
- Literature review of MBO pathophysiology and treatment modalities.
- Analysis of surgical, interventional (stenting), and medical approaches.
Main Results:
- Surgery is viable for select patients with operable lesions and good performance status.
- Self-expanding metallic stents offer a minimally invasive palliative option.
- Medical management is crucial for most MBO patients, controlling symptoms effectively.
Conclusions:
- MBO requires a multidisciplinary approach.
- While surgery and stenting have roles, medical management is key for symptom control in the majority of MBO patients.
- Understanding MBO pathophysiology informs comprehensive treatment strategies.
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