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18.10.2021 | Gastrointestinal Oncology

Malignant Bowel Obstruction Management Over Time: Are We Doing Anything New? A Current Narrative Review

verfasst von: Farhana Shariff, MDCM, MSc (HPE), FRCSC, Jessica Bogach, MD, FRCSC, Keegan Guidolin, MD, Ashlie Nadler, MD, MPH, MSc, FRCSC

Erschienen in: Annals of Surgical Oncology | Ausgabe 3/2022

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Abstract

Introduction

Malignant bowel obstruction from peritoneal carcinomatosis affects a significant proportion of luminal gastrointestinal and ovarian oncology patients, and portends poor long-term survival. The management approach for these patients includes a range of medical therapies and surgical options; however, how to select an optimal treatment strategy remains enigmatic. The goal of this narrative review was to summarize the latest evidence around multimodal malignant bowel obstruction treatment and to establish if and where progress has been made.

Methods

A targeted literature search examining articles focused on the management of malignant bowel obstruction from peritoneal carcinomatosis was performed. Following data extraction, a narrative review approach was selected to describe evidence and guidelines for surgical prognostic factors, imaging, tube decompression, medical management, nutrition, and quality of life.

Results

Outcomes in the literature to date are summarized for various malignant bowel obstruction treatment strategies, including surgical and non-surgical approaches, as well as a discussion of the role of total parenteral nutrition and chemotherapy in holistic malignant bowel obstruction management.

Conclusion

There has been little change in survival outcomes in malignant bowel obstruction in over more than a decade and there remains a paucity of high-level evidence to direct treatment decision making. Healthcare providers treating patients with malignant bowel obstruction should work to establish consensus guidelines, where feasible, to support medical providers in ensuring compassionate care during this often terminal event for this unique patient group.

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Titel: Malignant Bowel Obstruction Management Over Time: Are We Doing Anything New? A Current Narrative Review
verfasst von: Farhana Shariff, MDCM, MSc (HPE), FRCSC
Jessica Bogach, MD, FRCSC
Keegan Guidolin, MD
Ashlie Nadler, MD, MPH, MSc, FRCSC
Publikationsdatum: 18.10.2021
Verlag: Springer International Publishing
Erschienen in: Annals of Surgical Oncology / Ausgabe 3/2022
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-021-10922-1

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Malignant Bowel Obstruction Management Over Time: Are We Doing Anything New? A Current Narrative Review

Abstract

Introduction

Methods

Results

Conclusion

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