Palliative treatment of intestinal obstruction in patients with gynecologic malignancies - single center experience
Palliative treatment of intestinal obstruction in patients with gynecologic malignancies - single center experience
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DOI：
10.5603/gp.2019.0086
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发表时间：
2019-01-01
影响因子：
1.3
通讯作者：
Derlatka, Pawel
中科院分区：
文献类型：
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作者：
Kacperczyk-Bartnik, Joanna;Symonides, Aleksandra Helena;Derlatka, Pawel
目的：肠梗阻是妇科晚期肿瘤患者的常见症状之一。姑息性治疗包括药物治疗、支架置入术以及手术切除梗阻原因。选择适当的治疗应基于对优点、缺点和可能的并发症的仔细和个别的评估。本研究的目的是分析非侵入性治疗的有效性在妇科恶性肿瘤患者患有肠梗阻。材料和方法：这是一个回顾性分析的因素与原发性非侵入性肠梗阻治疗的有效性。数据收集自一个妇科肿瘤中心的17名患者的病历，这些患者因子宫内膜癌、输卵管癌、子宫平滑肌肉瘤和卵巢癌因症状性肠梗阻而入院。平均观察时间为40.6个月。非侵入性治疗包括液体疗法、地塞米松、Buscolysin、美贝维林、雷尼替丁、西甲硅油、奥美拉唑、硫酸镁、半流质饮食和肠外营养。特征包括年龄，体重指数，合并症，肿瘤治疗，组织学类型，阶段，等级，腹水的存在，原发肿瘤和转移的位置进行了analysed.Results：梗阻发作的数量从1到5不等。多次发作的平均间隔时间为3.2个月。5例患者需要手术治疗。对于其余的患者主要的非侵入性治疗是sufficient.Conclusions：大多数情况下，晚期妇科恶性肿瘤患者的肠梗阻可以成功地管理，而无需侵入性治疗。此外，在复发的情况下，可以多次应用非侵入性阻塞管理。
Objectives: One of the common symptoms in patients with advanced gynecologic tumors is intestinal obstruction. Palliative management may include pharmacological treatment, stenting as well as surgical removal of obstruction cause. Selection of appropriate treatment should be based on careful and individual assessment of advantages, disadvantages and possible complications. The aim of the study was to analyze the effectiveness of non-invasive treatment in patients with gynecologic malignancies suffering from intestinal obstruction.Material and methods: It was a retrospective analysis of factors associated with primary non-invasive intestinal obstruction treatment effectiveness. Data were collected from medical records of 17 patients managed and followed-up in a single gynecologic oncology center due to endometrial cancer, fallopian tube cancer, uterine leiomyosarcoma, and ovarian cancer admitted to the ward because of symptomatic intestinal obstruction. Mean observation time lasted 40.6 months. Non-invasive treatment included fluid therapy, dexamethasone, buscolysin, mebeverine, ranitidine, simethicone, omeprazole, magnesium sulphate, semi-liquid diet, and parenteral nutrition. Characteristics including age, BMI, comorbidities, oncological treatment, histology type, stage, grade, presence of ascites, location of primary tumor and metastases were analyzed.Results:The number of obstruction episodes varied from 1 to 5. Mean time between multiple episodes lasted 3.2 months. 5 patients required surgical treatment. For the rest of the patients primary non-invasive treatment was sufficient.Conclusions: Most cases of bowel obstruction in patients with advanced gynecologic malignancies can be successfully managed without invasive treatment. Moreover, non-invasive obstruction management can be applied multiple times in case of recurrence.