Palliative surgery treatment in patients with complete malignant bowel obstruction retrospective cohort study

Malignant bowel obstruction (MBO) is a condition secondary to intra-abdominal metastatic spread of advanced stage tumors. In this study, we aimed to evaluate the results of in the patients who were diagnosed with complete MBO and underwent palliative surgery treatment and to bring them to the attention of physicians.

The patients who were treated for cancer and who were consulted from the surgery clinic due to MBO symptoms between January 2022 and December 2023 were identified and recorded. The age of the patients included in the study, computed tomography findings, oral food intake at the time of diagnosis and after treatment, nasogastric tube removal, symptom relief, hospital readmissions, total length of hospital stay, development of complications, hospital stay, and survival rates of the patients were compared.

The average age of the 24 patients in the study (13 females and 11 males) were 64.2 ± 10.07 years (range: 45-80). All patients underwent surgical treatment. In terms of the primary diagnosis of the patients, 12 patients (50%) had colorectal, 4 patients (16.6%) gastric, 3 patients (12.5%) ovarian, and 2 patients (8.3%) bladder cancers, while 2 patients (8.3%) had intra-abdominal spread of lung tumor and 1 patient (4.1%) had cancer of small intestine origin. In the evaluation of the level of obstruction in patients, it was observed that 11 patients (45.8%) had small intestine, 7 patients (29.1%) had colon obstruction while 6 patients (25%) developed colon and small intestine obstruction together. The length of stay in the hospital was 8.8 ± 5.5 days, recovery from nasogastric tube was 100%, the rate of restoring the oral food intake was 79%, and the rate of readmission to the hospital with the same complaints was 25%.

The aim of palliative treatment is to increase the quality of life by eliminating the symptoms that impair the patient's quality of life. According to our results, palliative surgery treatment in appropriate patients had positive effects on the patient's quality of life. Further studies are needed to develop a common algorithm that would facilitate physicians' decision-making in the selection of medical or palliative surgical treatment.