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Malignant intestinal obstruction

R T Osteen, S Guyton, G Steele

    Surgery
    |June 1, 1980
    PubMed
    Summary
    This summary is machine-generated.

    Approximately one third of post-cancer treatment intestinal obstructions are benign. Cancerous obstructions are more likely with metastatic disease, advanced stage, or short treatment intervals, necessitating timely intervention.

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    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Oncology

    Background:

    • Intestinal obstruction is a significant complication following cancer treatment.
    • Differentiating benign from malignant causes of obstruction is crucial for patient management.

    Purpose of the Study:

    • To investigate the causes of intestinal obstruction in patients treated for cancer.
    • To identify factors associated with malignant bowel obstruction.
    • To evaluate the efficacy of non-operative management for incomplete obstructions.

    Main Methods:

    • Retrospective review of 66 consecutive patients with intestinal obstruction post-cancer treatment.
    • Analysis of patient history, cancer stage, and treatment intervals.
    • Assessment of outcomes following nasogastric suction and surgical intervention.

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    Main Results:

    • One-third of obstructions were benign.
    • Factors increasing likelihood of malignant obstruction included metastatic cancer, prior colorectal cancer, advanced primary stage, and short treatment interval.
    • Non-operative management (nasogastric suction) resolved 24% of incomplete obstructions, but 41% required reoperation for recurrence.
    • Optimal trial of nasogastric suction was limited to 3 days.

    Conclusions:

    • A significant proportion of intestinal obstructions post-cancer therapy have benign etiologies.
    • Malignant bowel obstruction is associated with specific clinical and pathological factors.
    • While nasogastric suction can provide temporary relief, surgical intervention is often required for definitive management of recurrent obstructions.