Best Palliation for Malignant Bowel Obstruction- A Retrospective study

Author(s): Laxmidhara Padhy, Saroj Kumar Barma, Pranay Kumar Patro

Objective: To determine the best palliative procedures undergone surgery and non-surgical procedures such as Chemotherapy/Stenting.

Background: Malignancy of Gastrointestinal tract starting from Oesophgus to Anus may cause acute or sub-acute obstruction which requires emergency relief from the symptoms. Surgery with diversion, colostomy or ileostomy, Nutritional Management with feeding gastrostomy/ jejunostomy and further chemoradiotherapy were required according to the different pathological variants at different site of G.I. tract to reduce the mortality rate and prolonging the survival time. Previous studies have been compared for the outcome of success rate,hospital stay,mean long term survival for different palliative interventions. None of them had proved to be most efficient for prolonged survival as most of cases were in the advanced stage of cancer.

Method: A retrospective study of Seventy patients of malignant bowel obstruction was done with statistical analysis.

Observation: Among the Seventy patients 49 were male and 21 were female and mean age of the patient was 49.57. The overall symptoms improve rate was 75.71%. Among them symptom improve rate 96% in surgical group,42.80% in stenting group and 15.38% are in chemotherapy group. Median survival time was 270 days in surgery group.

Conclusion: Malignant obstruction is an emergency condition in most of times needs urgent symptom relief by any mean of palliation. Complete and unresectable malignant obstruction needs diversion colostomy or any by-pass surgeries. Among all type of surgeries resection and anastomosis with or without diversion of loop is best palliation.