Outcome prognostic factors in inoperable malignant bowel obstruction

Romeo, Margarita; Gil, María de los Llanos; Urteaga, J.L. Cuadra; Vilà, Laia; Ahlal, Sara; Indacochea, Alberto; Pardo, Núria; Raduà, Joaquim; Font, Albert; Tuca, Albert

doi:10.1007/s00520-016-3299-7

Cited by 17 publications

(8 citation statements)

References 20 publications

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“…Patients with malignant bowel obstruction should be carefully selected for treatment with the aim of improving their quality of life [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Who Would Benefit from Nasointestinal tube in Small Bowel Obstruction?—A Matched Case-Control Study

Wang

Zhang

Chen

et al. 2021

Preprint

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Background: Nasointestinal tubes (NITs) have been increasingly used in patients with small bowel obstruction (SBO); However, severe adverse events (SAEs) of NITs might threaten the lives of patients. The indications of NITs need to be identified. This study was designed to explore the indications for the insertion of NITs in patients with SBO and to suggest the optimal strategies for individuals based on the outcomes of SAEs.Methods: After propensity score matching, 68 pairs were included (Success group and failure group). The occurrence of SAEs and the clinical parameters were compared between the SAE group and the non-SAE group. Independent risk factors were evaluated among the subgroups. A novel scoring system was established to detect the subgroups that would benefit from NITs insertion.Results: Successful implementation of NITs could avoid hypochloremia (p=0.010), SAEs (p=0.001), pneumonia (p=0.006). SAEs occurred in 13 of 136 (9.6%) patients who accepted NITs insertion treatment. Risk factors for SAEs included tumors (p=0.002), reduced BMI (p=0.048), reduced hemoglobin (p=0.001), abnormal activated partial thromboplastin time (p=0.015) and elevated white blood cells (p=0.002). A novel risk scoring system consists of hemoglobin before NITs insertion (95% CI: 0.685, 0.893) and bowel obstruction symptoms relieved after NITs insertion (95% CI: 0.575, 0.900) had the highest area under curve (AUC) for predicting the occurrence of SAEs. We divided the risk score system into 3 grades, with the increasing grades, the rates of SAEs surged from 1.3% (1/74) to (6/11) 54.5%.Conclusion: NITs successfully insertion could avoid SAEs occurrence in SBO conservative treatment. SBO patients without anemia and could be relieved after NITs insertion could be the potential benefit group for this therapy.

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“…Patients with malignant bowel obstruction should be carefully selected for treatment with the aim of improving their quality of life [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Who Would Benefit from Nasointestinal tube in Small Bowel Obstruction?—A Matched Case-Control Study

Wang

Zhang

Chen

et al. 2021

Preprint

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“…In our study, hypoalbuminemia was associated with higher in-hospital mortality and higher 90-day mortality. The use of parenteral nutrition during the perioperative period, while questionable in palliative patients (28), should be considered in selected cases.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Malignant Intestinal Obstruction: Outcome and Prognostic Factors

Bento¹,

Bianchi²,

Tustumi³

et al. 2019

chr

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Context: Ocluzia intestinală de cauză malignă este o complicaţie frecventă la pacienţii cu cancer în stadii avansate. Prognosticul este slab, cu o rată medie de supravieţuire mai mică de 3 luni. Tratamentul clinic, procedurile endoscopice sau chirurgicale sunt opţiuni pentru managementul obstrucţiei intestinale maligne. Nu există o strategie de management general acceptată. Obiective: Evaluarea factorilor de prognostic ai pacienţilor cu obstrucţie intestinală malignă care au fost supuşi unui tratament chirurgical. Metode: A fost efectuată o analiză retrospectivă incluzând pacienţii unei singure instituţii medicale, cu diagnostic de obstrucţie intestinală malignă. Au fost evaluate datele demografice, perioada de internare, complicaţiile postoperatorii şi supravieţuirea globală. Regresia logistică a fost utilizată pentru evaluarea factorilor prognostici asociaţi. Rezultate: Două sute treizeci şi trei de intervenţii chirurgicale au fost efectuate datorită suspiciunii de obstrucţie intestinală malignă pe o perioadă de şapte ani. Acest diagnostic a fost confirmat în cazul a 210 intervenţii chirurgicale (90,1%). Principalele cauze ale obstrucţiei maligne au fost cancerul colorectal (49,5%) şi cancerul ginecologic (21,9%). Rata complicaţiilor severe a fost de 11,42%. Rata mortalităţii intraspitaliceşti a fost de 40,95% (interval de încredere 95%: 34,16-47,74%). Deficienţa funcţională, ureea serică crescută şi nivelurile scăzute de albumină au fost asociate cu o rată mai mare a mortalităţii. Concluzie: Obstrucţia intestinală malignă implică prognostic slab, cu o rată ridicată a mortalităţii intraspitaliceşti şi complicaţii postoperatorii severe. Decizia privind gestionarea obstrucţiei intestinale maligne trebuie să fie multimodală şi individualizată, în funcţie de factorii de prognostic individuali.

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“…As a result of a poor nutritional status and the multilevel obstructions found in malignant adhesive obstructive bowel patients, treatment is more complicated. Only 30-48.9% of the patients have been successfully treated, as mentioned in the literature (17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%

Outcome of decompression using a transnasal ileus tube in malignant adhesive bowel obstruction: A retrospective study

Han¹,

Zhao²,

Su³

et al. 2017

Molecular and Clinical Oncology

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Outcome prognostic factors in inoperable malignant bowel obstruction

Abstract: A functional physiopathologic mechanism of MBO development may be an early prognostic factor for desobstruction. A high proportion of desobstruction was observed, suggesting that the combination of antisecretories with different mechanism of action warrants further investigation.

Cited by 17 publications

References 20 publications

Who Would Benefit from Nasointestinal tube in Small Bowel Obstruction?—A Matched Case-Control Study

Who Would Benefit from Nasointestinal tube in Small Bowel Obstruction?—A Matched Case-Control Study

Surgical Management of Malignant Intestinal Obstruction: Outcome and Prognostic Factors

Outcome of decompression using a transnasal ileus tube in malignant adhesive bowel obstruction: A retrospective study

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