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Title: Surgical Management of Malignant Intestinal Obstruction: Outcome and Prognostic Factors
Authors: SOUSA, Jorge Henrique Bento deBIANCHI, Edno TalesTUSTUMI, FranciscoLEONARDI, Paulo CesarRIBEIRO JUNIOR, UlyssesCECONELLO, 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
Departamento de Gastroenterologia - FM/MGT

Artigos e Materiais de Revistas Científicas - HC/ICESP
Instituto do Câncer do Estado de São Paulo - HC/ICESP

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - LIM/24
LIM/24 - Laboratório de Oncologia Experimental

Artigos e Materiais de Revistas Científicas - LIM/35
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar

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