Department of General Surgery, University of Health Sciences, Bağcılar Training and Research Hospital, İstanbul-Turkey.
Department of General Surgery, Tokat Gaziosmanpaşa University Faculty of Medicine, Tokat-Turkey.
Ulus Travma Acil Cerrahi Derg. 2020 Nov;26(6):875-882. doi: 10.14744/tjtes.2020.90250.
Malignant bowel obstruction (MBO) is a condition secondary to intra-abdominal metastatic spread of advanced-stage tumors. There is no consensus for the treatment approach of MBO. This study aims to present the results of medical treatment and palliative surgery in patients diagnosed with MBO.
The patients who were treated for advanced-stage tumors between 2010 and 2017 and for whom consultation was requested from the surgical clinic for MBO symptoms were identified. A selective approach together with palliative care for the indication of surgery was instituted. The patients with surgical treatment and medical treatment were compared concerning survival, oral food intake and symptom relief.
Seventy-six patients (30 female, 46 male) aged 60.5±12.8 years (range: 27-88) were included in this study. Forty-eight of the patients (64.9%) underwent surgical treatment, while 28 (35.1%) had medical treatment. Although the patients with surgery had longer duration of stay in the hospital (median 16 days vs. 4 days) (p<0.001) and higher complication rates (27.1% vs. 3.5%) compared to medically treated patients; the restoring oral food intake was better (97.9% vs. 78.6%) (p=0.005) and the survival was longer (105 days vs. 43 days).
This study revealed that surgical treatment resulted in better outcomes for life quality parameters in highly selected patients with malignant bowel obstruction evaluated by multidisciplinary team, including palliative care.
恶性肠梗阻（MBO）是晚期腹腔内转移性肿瘤的一种并发症。对于 MBO 的治疗方法尚未达成共识。本研究旨在介绍诊断为 MBO 的患者接受药物治疗和姑息性手术的结果。
我们确定了 2010 年至 2017 年间接受晚期肿瘤治疗且因 MBO 症状向外科诊所咨询的患者。对于手术适应证，我们采用了选择性方法并结合姑息治疗。对接受手术治疗和药物治疗的患者的生存情况、口服食物摄入和症状缓解进行了比较。
本研究共纳入 76 例患者（30 名女性，46 名男性），年龄 60.5±12.8 岁（范围：27-88 岁）。其中 48 例（64.9%）患者接受了手术治疗，28 例（35.1%）接受了药物治疗。尽管手术组患者的住院时间（中位数 16 天 vs. 4 天）（p<0.001）和并发症发生率（27.1% vs. 3.5%）更高，但恢复口服食物摄入的比例更好（97.9% vs. 78.6%）（p=0.005），生存时间更长（105 天 vs. 43 天）。
本研究表明，对于经过多学科团队（包括姑息治疗）评估的高度选择的恶性肠梗阻患者，手术治疗可改善生活质量参数的结局。
