The role of intestinal intubation in obstruction of the small intestine due to carcinoma of the ovary.

A total of 165 episodes of obstruction of the small intestine associated with carcinoma of the ovary were evaluated retrospectively to define the role of intestinal intubation. Patients with prolonged tube suctioning (greater than 48 hours) had a significantly higher operative mortality than patients operated upon immediately without prior intubation or after short term intubation of no longer than 48 hours (p less than 0.05). When controlled for risk factors, such as age, tumor status, ascites and amount and type of prior therapy, the difference between the groups was no longer significant (p greater than 0.1). Another variable of importance was the response to tube suction as documented by serial plain roentgenograms of the abdomen. Prolonged tube suction did not result in increased morbidity compared with short term intestinal intubation (p greater than 0.1) if decompression of the small intestine was accomplished within 48 hours of admission. Nonoperative therapy by intestinal intubation rarely relieves small intestinal obstruction caused by carcinoma of the ovary. It may, however, relieve distension of the small intestine proximal to the obstruction, thus preventing anatomic and metabolic changes that contribute to poor outcome when surgical treatment for relief of the obstruction is delayed.