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https://observatorio.fm.usp.br/handle/OPI/33489
Title: | Surgical Management of Malignant Intestinal Obstruction: Outcome and Prognostic Factors |
Authors: | SOUSA, Jorge Henrique Bento de; BIANCHI, Edno Tales; TUSTUMI, Francisco; LEONARDI, Paulo Cesar; RIBEIRO JUNIOR, Ulysses; CECONELLO, Ivan |
Citation: | CHIRURGIA, v.114, n.3, p.343-351, 2019 |
Abstract: | Background:Malignant intestinal obstruction is a frequent complication in advanced stages cancer patients. The prognosis is poor, with mean survival rate beneath 3 months. Clinical treatment, endoscopic or surgical procedures are options for malignant intestinal obstruction management. There is no generally accepted management strategy. Objectives: To evaluate prognostic factors of patients with malignant intestinal obstruction who underwent surgical treatment. Methods: A retrospective analysis was performed including patients of a single institution with diagnosis of malignant intestinal obstruction. Demographic data, in-hospital stay, postoperative complications, and overall survival were assessed. Logistic regression was used to evaluate associated prognostic factors. Results: Two hundred thirty-three surgeries were performed due to suspicion for malignant intestinal obstruction over a seven-year period. This diagnosis was confirmed in 210 operations (90.1%). The main causes of malignant obstruction were colorectal (49.5%) and gynecological cancer (21.9%). The rate of severe complications was 11.42%. In-hospital mortality rate was 40.95% (CI 95%: 34.16-47.74%). Functional status impairment,high serum urea, and low albumin levels were associated to higher mortality rate. Conclusion: Malignant intestinal obstruction implies poor prognosis, with high in-hospital mortality rate and severe postoperative complications. The decision regarding management of malignant intestinal obstruction must be multimodal and individualized, according to individual prognostic factors. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MGT Artigos e Materiais de Revistas Científicas - HC/ICESP Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - LIM/24 Artigos e Materiais de Revistas Científicas - LIM/35 Artigos e Materiais de Revistas Científicas - ODS/03 |
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