دورية أكاديمية
أعرض في EDS

Outcomes of patients admitted with malignant small bowel obstruction: a subgroup multicentre observational cohort analysis.

التفاصيل البيبلوغرافية
العنوان: Outcomes of patients admitted with malignant small bowel obstruction: a subgroup multicentre observational cohort analysis.
المؤلفون: Hupfeld NB; Department of Surgery, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark. nanna.baekvang.hupfeld@regionh.dk., Burcharth J; Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark., Jensen TK; Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark., Lolle I; Department of Surgery, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark., Nielsen LBJ; Digestive Disease Center, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark., Tolver MA; Department of Surgery, Sjaelland University Hospital, Koege, Denmark., Skovsen AP; Department of Surgery, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark., Smith HG; Digestive Disease Center, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark.; Department of Surgery, Slagelse Hospital, Slagelse, Denmark.
المصدر: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2024 Aug 06; Vol. 409 (1), pp. 239. Date of Electronic Publication: 2024 Aug 06.
نوع المنشور: Journal Article; Multicenter Study; Observational Study
اللغة: English
بيانات الدورية: Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 9808285 Publication Model: Electronic Cited Medium: Internet ISSN: 1435-2451 (Electronic) Linking ISSN: 14352443 NLM ISO Abbreviation: Langenbecks Arch Surg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Berlin : Springer-Verlag, c1998-
مواضيع طبية MeSH: Intestinal Obstruction*/etiology , Intestinal Obstruction*/mortality , Intestinal Obstruction*/surgery , Intestine, Small*/pathology , Palliative Care*, Humans ; Male ; Female ; Aged ; Middle Aged ; Aged, 80 and over ; Treatment Outcome ; Adult ; Cohort Studies ; Survival Rate ; Intestinal Neoplasms/mortality ; Intestinal Neoplasms/complications ; Intestinal Neoplasms/pathology ; Intestinal Neoplasms/surgery
مستخلص: Introduction and Purpose of the Study: Small bowel obstruction (SBO) accounts for a substantial proportion of emergency surgical admissions. Malignancy is a common cause of obstruction, either due to a primary tumour or intra-abdominal metastases. However, little is known regarding the current treatment or outcomes of patients with malignant SBO. This study aimed to characterise the treatment of malignant SBO and identify areas for potential improvement and compare overall survival of patients with malignant SBO to patients with non-malignant SBO.
Materials and Methods: This was a subgroup analysis of a multicentre observational study of patients admitted with SBO. Details regarding these patients' diagnoses, treatments, and outcomes up to 1-year after admission were recorded. The primary outcome was overall survival in patients with malignant SBO.
Results: A total of 316 patients with small bowel obstruction were included, of whom 33 (10.4%) had malignant SBO. Out of the 33 patients with malignant SBO, 20 patients (60.6%) were treated with palliative intent although only 7 patients were seen by a palliative team during admission. Nutritional assessments were performed on 12 patients, and 11 of these patients received parenteral nutrition. 23 patients underwent surgery, with the most common surgical interventions being loop ileostomies (9 patients) and gastrointestinal bypasses (9 patients). 4 patients underwent right hemicolectomies, with a primary anastomosis formed and 1 patient had a right hemicolectomy with a terminal ileostomy. Median survival was 114 days, and no difference was seen in survival between patients treated with or without palliative intent.
Conclusion: Malignant SBO is associated with significant risks of short-term complications and a poor prognosis. Consideration should be given to the early involvement of senior decision-makers upon patient admission is essential for optimal management and setting expectation for a realistic outcome.
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: Malignant small bowel obstruction; Operative vs. non-operative management; Overall survival; Palliative care
تواريخ الأحداث: Date Created: 20240806 Date Completed: 20240806 Latest Revision: 20240808
رمز التحديث: 20240808
DOI: 10.1007/s00423-024-03436-3
PMID: 39105830
قاعدة البيانات: MEDLINE
الوصف
تدمد:1435-2451
DOI:10.1007/s00423-024-03436-3