PROGNOSTIC FACTORS AFFECTING OUTCOME OF PALLIATIVE SURGERY FOR MALIGNANT BOWEL OBSTRUCTION IN ADVANCED GASTROENTEROLOGICAL CANCER PATIENTS

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We assessed the food intake in terminal cancer patients who underwent palliative surgery (ostomy placement or bypass operation) for malignant bowel obstruction, and evaluated the factors affecting the outcome of palliative surgery. Sixty patients who underwent palliative surgery for malignant bowel obstruction were enrolled in this study and they were divided into two groups, depending on the ability to tolerate solid foods. We analyzed the two groups for the following clinical factors: primary diagnosis, obstruction level, preoperative albumin level, performance status, surgical procedure, presence of ascites, dissemination, remote metastases and pre-operative chemotherapy. Thirty-four patients were able to tolerate solid foods for one month or longer after surgery. Patients with preoperative serum albumin level of <3.0g/dl, with the presence of ascites or whose primary site was the pancreas, could not tolerate solid foods significantly. A multiple logistic regression analysis indicated that the pancreas primary, preoperative low albumin level and the presence of ascites are the independent predictors for an unfavorable postoperative outcome of food intake. Those three clinical factors would be important for predicting the outcome of palliative surgery.
日本臨床外科学会の論文