Resection of peritoneal metastases causing malignant small bowel obstruction
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Resection of peritoneal metastases causing malignant small bowel obstruction Saleh M Abbas* and Arend EH Merrie Address: Colorectal Unit, Auckland City Hospital, Private Bag 92024, Auckland, New Zealand Email: Saleh M Abbas* - [email protected]; Arend EH Merrie - [email protected] * Corresponding author
Published: 24 October 2007 World Journal of Surgical Oncology 2007, 5:122
doi:10.1186/1477-7819-5-122
Received: 1 June 2007 Accepted: 24 October 2007
This article is available from: http://www.wjso.com/content/5/1/122 © 2007 Abbas and Merrie; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Resection of peritoneal metastases has been shown to improve survival in patients with abdominal metastatic disease from abdominal or extra abdominal malignancy. This study evaluates the benefit of peritoneal metastatic resection in patients with malignant small bowel obstruction and a past history of treated cancer. Patients and methods: Patients undergoing laparotomy for resection of peritoneal metastases from recurrence of previous cancer between 1992–2003 were reviewed retrospectively. Data were collected about type of primary cancer, interval to recurrence, extent of the disease and completeness of resection, morbidity and mortality and long-term survival. Results: Between 1992 and 2003 there were 79 patients (median age 62, range 19–91) who had laparotomy for small bowel obstruction due to recurrent cancer. The primary cancer was colorectal (31), gynaecologic cancer (19), melanoma (16) and others (13). Overall, the rate of complications was 35% and mortality was 10%. Median survival was 5 months; patients with history of colorectal cancer had better survival than other cancer (median survival 7 months vs. 4 months; p = 0.02). Multivariate analysis showed that the extent of recurrent disease was the only factor that affected overall survival. Conclusion: Laparotomy for small bowel obstruction is a worthwhile option for patients with malignant small bowel obstruction. Although it is associated with significant morbidity and mortality it offers a reasonable survival benefit in particular for patients with completely resectable disease.
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World Journal of Surgical Oncology 2007, 5:122
http://www.wjso.com/content/5/1/122
Background Bowel obstruction in patients with history of cancer is caused by recurrence of cancer in 50% of patients [1,2]. In patients with previously treated colorectal cancer with curative intent 10% develop small bowel obstruction; half of them are due to recurrence [2]. Small bowel obstruction due to recurrent cancer is commonly caused by colorectal cancer, ovarian malignancies, and malignant melanoma [3-5]. Small bowel obstruction due to recurrent can
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