Observational Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2015; 21(8): 2467-2474
Published online Feb 28, 2015. doi: 10.3748/wjg.v21.i8.2467
Percutaneous needle decompression in treatment of malignant small bowel obstruction
Ting-Hui Jiang, Xian-Jun Sun, Yue Chen, Hui-Qin Cheng, Shi-Ming Fang, Hao-Sheng Jiang, Yan Cao, Bing-Yan Liu, Shao-Qiu Wu, Ai-Wu Mao
Ting-Hui Jiang, Xian-Jun Sun, Shi-Ming Fang, Hao-Sheng Jiang, Yan Cao, Bing-Yan Liu, Shao-Qiu Wu, Ai-Wu Mao, Interventional Center, St. Luke’s Hospital of Jiaotong University School of Medicine, Shanghai 200050, China
Yue Chen, Department of Radiology, Renji Hospital of Shanghai Jiaotong University School of Medicine, Shanghai 200001, China
Hui-Qin Cheng, Yangpu Daqiao Community Healthy Service Center, Shanghai 200090, China
Author contributions: Jiang JH, Sun XJ, Mao AW designed the Study; Jiang JH, Sun XJ, Fang SM, Jiang HS, Wu SQ, and Mao AW performed the research; Chen Y, Cheng HQ, Cao Y, and Liu BY contributed new reagents or analytic tools; Sun XJ, Chen Y, and Cheng HQ analyzed the data; Jiang JH, Sun XJ, and Mao AW wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ai-Wu Mao, MD, Professor, Chief, Interventional Center, St. Luke’s Hospital of Jiaotong University School of Medicine, No. 786 Yuyuan Road, Shanghai 200050, China. maoaw@sohu.com
Telephone: +86-21-62524259-3397 Fax: +86-21-62113884
Received: August 15, 2014
Peer-review started: August 17, 2014
First decision: September 15, 2014
Revised: September 29, 2014
Accepted: December 8, 2014
Article in press: December 8, 2014
Published online: February 28, 2015
Processing time: 196 Days and 18 Hours
Abstract

AIM: To investigate the efficacy and safety of percutaneous needle decompression in the treatment of malignant small bowel obstruction (MSBO).

METHODS: A prospective analysis of the clinical data of 52 MSBO patients undergoing percutaneous needle decompression was performed.

RESULTS: Percutaneous needle decompression was successful in all 52 patients. Statistically significant differences were observed in symptoms such as vomiting, abdominal distension and abdominal pain before and after treatment (81.6% vs 26.5%, 100% vs 8.2%, and 85.7% vs 46.9%, respectively; all P < 0.05). The overall significantly improved rate was 19.2% (11/52) and the response rate was 94.2% (49/52) using decompression combined with nasal tube placement, local arterial infusion of chemotherapy and nutritional support. During the one-month follow-up period, puncture-related complications were acceptable.

CONCLUSION: Percutaneous needle intestinal decompression is a safe and effective palliative treatment for MSBO.

Keywords: Arterial infusion chemotherapy; Malignant small bowel obstruction; Nasal intestinal decompression tube; Percutaneous needle decompression; Palliative treatment

Core tip: Malignant small bowel obstruction (MSBO) is a common complication in patients with advanced cancer. In this study, we prospectively analyzed MSBO patients undergoing percutaneous needle decompression in our hospital over the past few years to identify the value of this technique in the palliative treatment of MSBO. We concluded that percutaneous needle intestinal decompression is a safe and effective palliative treatment for MSBO. When combined with local arterial infusion of chemotherapy and nasal intestinal decompression tube placement, percutaneous needle decompression can further improve the clinical remission.