Results of surgery for malignant bowel obstruction in advanced, unresectable, recurrent colorectal cancer
| Autor: | Theo G. Lorentz, Peter W. K. Lau |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Adult
Male medicine.medical_specialty Palliative care medicine.medical_treatment Rectum Postoperative Complications Recurrence Surgical oncology Laparotomy Humans Medicine Aged Retrospective Studies Aged 80 and over business.industry General surgery Palliative Care Gastroenterology Retrospective cohort study General Medicine Middle Aged medicine.disease Colorectal surgery Surgery Bowel obstruction medicine.anatomical_structure Female Neoplasm Recurrence Local Colorectal Neoplasms business Complication Intestinal Obstruction |
| Zdroj: | Diseases of the Colon & Rectum. 36:61-64 |
| ISSN: | 0012-3706 |
| DOI: | 10.1007/bf02050303 |
| Popis: | When conservative treatment fails in the management of patients with malignant bowel obstruction secondary to advanced, recurrent colorectal cancer, the attitude toward surgery is often less than enthusiastic because of the limited life expectancy. We report a retrospective review of 30 patients with unresectable intra-abdominal disease who underwent laparotomy for the relief of bowel obstruction. Normal bowel function was restored in 19 patients (63 percent). The failures included five patients (17 percent) who died as a result of surgical complications and six patients (20 percent) who despite the surgery had continuing obstruction. Postoperative complications occurred in eight patients (27 percent). The median survival was significantly improved in those who benefited from the operation (192 days vs. 26 days; P = 0.0001). Whether the obstruction occurred at one site or more than one site appeared not to influence the outcome of surgery. Obstruction recurred after a mean symptom-free interval of 120 days in eight of those relieved by the initial operation. Half of these patients responded to conservative treatment, and surgery was again beneficial in three of the remaining four. Our results justify a more positive approach toward this problem, and, when conservatism fails, laparotomy should be undertaken in those who are not terminally ill. |
| Databáze: | OpenAIRE |
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