Published online Mar 15, 2020. doi: 10.4251/wjgo.v12.i3.323
Peer-review started: September 27, 2019
First decision: November 18, 2019
Revised: November 27, 2019
Accepted: January 14, 2020
Article in press: January 14, 2020
Published online: March 15, 2020
Processing time: 167 Days and 4.1 Hours
Malignant bowel obstruction (MBO) is a frequent event for end-stage malignant cancers. There is no consensus on the optimal treatment strategy for improving quality of life and prolonging survival. There were fewer studies focused on the surgical intervention of MBO with gastrointestinal (GI) cancers.
We wanted to investigate the effects of palliative surgery for MBO in patients with GI cancers in order to guide treatment.
To define the surgical outcome difference between massive debulking surgery (MDS) and ostomy/by-pass surgery (OBS) for MBO patients with GI cancer.
MBO patients with GI cancer receive palliative surgery were included MDS group and OBS group. This study mainly investigated the difference of short outcome and survival between the two groups.
This study reported that patients in the MDS group had significantly higher symptom palliation rate than OBS group, and the median survival time in the MDS group was significantly longer than in the OBS group.
Massive debulking surgery can significantly improve symptom and prolong survival for MBO patients with colorectal cancer, without increasing mortality and morbidity rates compared with ostomy/by-pass surgery. However, MDS had no such advantage in gastric cancer.
The treatment of MBO remained controversial and no well-evidenced. This small sample study demonstrates the effectiveness, safety and survival benefit of massive debulking surgery in colorectal cancer patients with MBO. It is difficult to carry out large sample randomized controlled study. In the future, it is necessary to establish a large sample registration study.