Surgical intervention for malignant bowel obstruction caused by gastrointestinal malignancies

Table 1 Clinicopathological features and survival of 61 malignant bowel obstruction cases

Clinicopathological features	n (%)	6-mo OS	Median survival time (mo)	P value
Gender				0.923
Male	38 (65.2)	54.7%	6.6
Female	23 (34.8)	59.2%	6.4
Age (yr)				0.516
≥ 60	33 (54.1)	50.4%	6.5
< 60	28 (45.9)	61.5%	10.6
Primary tumor				0.015
Colorectal	51 (69.6)	83.6%	10.6
Gastric	10 (30.4)	16.4%	1.8
Differentiation				0.005
Well + Moderate	41 (67.2)	71.5%	10.9
Poor	20 (32.8)	26.5%	4.1
ECOG				0.031
0-1	40 (65.6)	64.4%	10.6
> 1	21 (34.4)	42.9%	5.1
Surgical approach				0.053
OBS	31 (50.8)	44.6%	5.3
MDS	30 (49.2)	68.6%	10.9
Obstruction				0.25
Single	41 (67.2)	57%	6.6
Multiple	20 (32.8)	55%	6.1
Intestinal obstruction				0.084
Yes	31 (50.8)	53.2%	6.1
No	30 (49.2)	60.1%	10.9
Colon/rectum obstruction				0.389
Yes	37 (60.7)	57.4%	10.9
No	24 (39.3)	54.8%	6.5
Ascites				0.691
Yes	15 (24.6)	41.1%	5.1
No	46 (75.4)	61.1%	6.6
Greater omentum metastasis				0.044
Yes	42 (68.9)	51.2%	6.1
No	19 (31.1)	67.5%	17.3
Distant metastasis				0.13
Yes	24 (39.3)	50%	5.2
No	37 (60.7)	60.4%	10.9
Symptom relief				0.007
Yes	46 (75.4)	63.7%	10.9
No	15 (24.6)	31.5%	3.9

OBS: Ostomy/by-pass surgery; MDS: Massive debulking surgery; ECOG: Eastern Cooperative Oncology Group; OS: Overall survival.

Table 2 Sixty-one cases of complications after surgery, n (%)

Complications	OBS group (n = 31)	MDS group (n = 30)
Pulmonary infection	6 (19.4)	4 (13.3)
Abdominal infection	2 (6.5)	4 (13.3)
Incision infection	3 (9.7)	4 (13.3)
Urinary tract infection	1 (3.2)	-
Diarrhea	-	1 (3.3)
Arrhythmia	1 (3.2)	-
Hemorrhage	1 (3.2)	4 (13.3)
Cerebral infarction	-	2 (6.7)
Short intestine	-	2 (6.7)
Necrosis of ostomy mucosa	2 (6.5)	-
Clavien-Dindo classification[16]
I	-	1(3.3)
II	9 (29)	13 (43.3)
III	-	-
IV	-	1 (2.3)
V	6 (19.4)	2 (6.7)

OBS: Ostomy/by-pass surgery; MDS: Massive debulking surgery.

Table 3 Multivariable analysis prognostic factors of 51 malignant bowel obstruction colorectal cancer patients

Variables	HR	95%CI	P value
Surgical approach (OBS vs MDS)	2.301	0.999-5.299	0.05
Greater omentum metastasis (Yes vs No)	7.718	2.224-26.782	0.001
Differentiation (Poor vs Well+ Moderate)	8.059	2.455-26.448	0.001
Distant organ metastasis (Yes vs No)	2.375	1.022-5.253	0.044

OBS: Ostomy/by-pass surgery; MDS: Massive debulking surgery; HR: Hazard ratio.