Management of malignant bowel obstruction.

Management of malignant bowel obstruction. Research Abstract Details 

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Management of malignant bowel obstruction. Abstract Text:

Malignant bowel obstruction (MBO) is a common and distressing outcome particularly in patients with bowel or gynaecological cancer. Radiological imaging, particularly with CT, is critical in determining the cause of obstruction and possible therapeutic interventions. Although surgery should be the primary treatment for selected patients with MBO, it should not be undertaken routinely in patients known to have poor prognostic criteria for surgical intervention such as intra-abdominal carcinomatosis, poor performance status and massive ascites. A number of treatment options are now available for patients unfit for surgery. Nasogastric drainage should generally only be a temporary measure. Self-expanding metallic stents are an option in malignant obstruction of the gastric outlet, proximal small bowel and colon. Medical measures such as analgesics according to the W.H.O. guidelines provide adequate pain relief. Vomiting may be controlled using anti-secretory drugs or/and anti-emetics. Somatostatin analogues (e.g. octreotide) reduce gastrointestinal secretions very rapidly and have a particularly important role in patients with high obstruction if hyoscine butylbromide fails. A collaborative approach by surgeons and the oncologist and/or palliative care physician as well as an honest discourse between physicians and patients can offer an individualised and appropriate symptom management plan.

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PUBLICATION TYPE: Journal Article

Journal: European journal of cancer (Oxford, England : 1990

VOLUME: 44

Page Numbers: 1105-15

Journal Abbreviation: Eur. J. Cancer

ISSN: 0959-8049

DAY: 21

MONTH: 03

YEAR: 2008

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LANGUAGE: eng

NlmUniqueID: 9005373

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AFFILIATION: Professor on Contract of Oncology (Teaching Palliative Medicine) at the School of Specialization in Oncology, University of Milan; Palliative Care Unit (Pain Therapy-Rehabilitation) IRCCS Foundation, National Cancer Institute, Milano Italy.

Country: England

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MEDLINETA: Eur J Cancer

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