Medical management of malignant bowel obstruction in patients with advanced cancer: 2021 MASCC guideline update

2021 ◽  
Author(s):  
Mellar Davis ◽  
David Hui ◽  
Andrew Davies ◽  
Carla Ripamonti ◽  
Andreia Capela ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Bowel Obstruction ◽  
Medical Management ◽  
Malignant Bowel Obstruction

scholarly journals Hospital utilization and disposition among patients with malignant bowel obstruction: a population-based comparison of surgical to medical management

BMC Cancer ◽  
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Sarah B. Bateni ◽  
Alicia A. Gingrich ◽  
Susan L. Stewart ◽  
Frederick J. Meyers ◽  
Richard J. Bold ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Medical Management ◽  
Population Based ◽  
Hospital Utilization ◽  
Malignant Bowel Obstruction

Safety and Efficacy of Venting Gastrostomy in Malignant Bowel Obstruction: A Systematic Review

2019 ◽  
Vol 35 (2) ◽  
pp. 93-102 ◽  
Author(s):  
Sreeharshan Thampy ◽  
Pavan Najran ◽  
Damian Mullan ◽  
Hans-Ulrich Laasch
Keyword(s):  
Systematic Review ◽  
Bowel Obstruction ◽  
Medical Management ◽  
Symptom Control ◽  
Complication Rates ◽  
Malignant Bowel Obstruction ◽  
Management Options ◽  
Safety And Efficacy ◽  
Nonsurgical Management ◽  
Abdominal Malignancy

Malignant bowel obstruction (MBO) is a common manifestation in patients with advanced intra-abdominal malignancy. It is especially common with bowel or gynecological cancers and produces distressing symptoms, including nausea, vomiting, and pain. Medical management options are less effective than decompressive strategies for symptom control. Surgery is the gold-standard treatment but is unsuitable for most patients with high complication rates. Consensus guidelines recommend nonsurgical management with a venting gastrostomy in those unsuitable for surgery or for whom medical management is ineffective. The aim of this systematic review is to establish the safety and efficacy of percutaneous venting gastrostomy in relieving symptoms of MBO. Twenty-five studies were included in this review comprising 1194 patients. Gastrostomy insertion was successful at first attempt in 91% of cases and reduction in symptoms of nausea and vomiting was reported in 92% of cases. Mean survival following the procedure ranged from 35 to 147 days. Major complications were rare, with most complications classed as minor wound infections or leakage of fluid around the tube. Studies suggest that the presence of ascites is not an absolute contraindication to the insertion of percutaneous venting gastrostomy in patients with MBO; however, these studies lack longitudinal outcomes and complication rates related to this. However, it is reasonable to suggest that ascitic drainage is performed to reduce potential complications. There is a relative lack of good quality robust data on the utilization of percutaneous venting gastrostomy in MBO, but overall, the combination of being a safe and efficacious procedure alongside the known complication profile suggests that it should be considered a suitable management option.

scholarly journals A REGIONAL RE-AUDIT OF THE SYMPTOMATIC MANAGEMENT OF NAUSEA & VOMITING IN THE MEDICAL MANAGEMENT OF MALIGNANT BOWEL OBSTRUCTION

2014 ◽  
Vol 4 (Suppl 1) ◽  
pp. A68.2-A68
Author(s):  
Timothy Jackson ◽  
David Waterman ◽  
Ashique Ahamed ◽  
Rebecca Lennon ◽  
Julie Suman ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Medical Management ◽  
Malignant Bowel Obstruction ◽  
Symptomatic Management

Medical Management of Inoperable Malignant Bowel Obstruction

2020 ◽  
pp. 106002802097977
Author(s):  
Xiaoyan Huang ◽  
Jing Xue ◽  
Min Gao ◽  
Qiyuan Qin ◽  
Tenghui Ma ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Effects ◽  
Bowel Obstruction ◽  
Medical Management ◽  
Case Reports ◽  
Somatostatin Analogs ◽  
Clinical Approach ◽  
Malignant Bowel Obstruction ◽  
Anti Inflammatory

Objective: To review medical management of inoperable malignant bowel obstruction. Data Sources: A literature review using PubMed and MEDLINE databases searching malignant bowel obstruction, etiology, types, pathophysiology, medical, antisecretory, anti-inflammatory, antiemetic drugs, analgesics, promotion of emptying, prevention of infection, anticholinergics, somatostatin analogs, gastric antisecretory drugs, prokinetic agents, glucocorticoid, opioid analgesics, antibiotics, enema, and adverse effects. Study Selection and Data Extraction: Randomized or observational studies, cohorts, case reports, or reviews written in English between 1983 and November 2020 were evaluated. Data Synthesis: Malignant bowel obstruction (MBO) commonly occurs in patients with advanced or recurrent malignancies and severely affects the quality of life and survival of patients. Its management remains complex and variable. Medical management is the cornerstone of MBO treatment, with the goal of reducing distressing symptoms and optimizing quality of life. Until now, there has been neither a standard clinical approach nor registered medications to treat patients with inoperable MBO. Relevance to Patient Care and Clinical Practice: This review provides information on the etiology, type and pathophysiology, and medical treatment of MBO and related adverse reactions of the drugs commonly used, which can greatly assist clinicians in making clinical decisions when treating MBO. Conclusions: Published research shows that medical management of MBO mainly consists of antisecretory, anti-inflammatory strategies, controlling vomiting and pain, promoting emptying, preventing infection, and combination therapy. Being knowledgeable about the most current treatment options, the related adverse effects, and the evidence supporting different practices is critical for clinicians to provide individualized medical therapy for MBO patients.

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