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Published on: March 24, 2023
Surgery for perforated small bowel malignancy: a single institution's experience over 4 years
Ker-Kan Tan1, Shieh-Ling Bang, Choon-Kiat Ho
1Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore. kerkan@gmail.com
Summary
Surgery for perforated small bowel malignancy carries high mortality. Patients undergoing emergency surgery for this condition face dismal long-term outcomes, underscoring the severity of malignant small bowel perforation.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Perforated small bowel malignancy presents significant surgical challenges.
- High morbidity and mortality rates are associated with emergency surgical intervention.
Purpose of the Study:
- To review the institution's surgical experience in managing malignant small bowel perforation.
- To analyze outcomes for patients undergoing surgery for this condition.
Main Methods:
- Retrospective review of patients undergoing surgery for malignant small bowel perforation (2004-2007).
- Histological confirmation of diagnosis.
- Analysis of peri-operative and long-term outcomes.
Main Results:
- Seven patients (age >55, ASA score ≥3) underwent emergency surgery.
- Common etiologies included lymphoma (4), leiomyosarcoma (1), and metastatic lung tumors (2).
- 30-day peri-operative mortality was 42.9%; long-term survival remained poor.
Conclusions:
- Malignant small bowel perforation is associated with high peri-operative mortality.
- Long-term prognosis for survivors of emergency surgery is dismal.
- Urgent surgical management is critical but outcomes remain poor.
