Small-Bowel Obstruction in Patients with a Previous History of Abdominal Surgery due to Cancer.
- Author:
Sung Ju LEE
1
;
Jae Kwan HWANG
;
Kyung Woo CHOI
Author Information
1. Department of Surgery, National Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Small-bowel obstruction;
Cancer
- MeSH:
Colorectal Neoplasms;
Humans;
Medical Records;
Mortality;
Ovarian Neoplasms;
Postoperative Complications;
Recurrence;
Retrospective Studies;
Risk Factors;
Stomach Neoplasms;
Survival Rate
- From:Journal of the Korean Surgical Society
2000;58(5):656-660
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The purpose of this study was to analyze the clinical features and to assess the risk factors in the treatment of small-bowel obstructions. METHODS: This retrospective clinical report was based on the medical records of 67 patients who were treated between Jan. 1992 and Dec. 1999 and who had had a history of abdominal surgery due to cancer. RESULTS: The distribution of primary cancer was as follows: stomach cancer 36 (53.7%), colorectal cancer 25 (37.3%), uterine and ovarian cancer 4 (6.0%), and other cancers 2 (3.0%). The mean interval from the primary operation to the development of a small- bowel obstruction was 27 months. Conservative treatment produced a successful outcome in 36 patients (59.0%), but recurrences of obstruction were noted in 18 of those patients. There were 34 operations in 30 patients. The initial success rate of operative treatment was 80% (24/30), obstructions recurred in 6 patients. The causes of obstructions in the surgically treated patients were adhesion (53.3%) and recurrence of cancer (46.7%). The postoperative complication rate was 44.1%, and the mortality rate was 20.0%. The mean survival time of the patients with benign causes of obstruction was significantly longer than that of the patients with malignant causes of obstruction (46 months vs 11 months). CONCLUSION: In the treatment of such patients, conservative treatment should be considered first. However if conservative treatment fails, surgery should be done without hesitation, especially in patients with no definite evidence of recurrence.
