PALLIATIVE SURGERY FOR INTESTINAL OBSTRUCTION DUE TO RECURRENT OVARIAN CANCER
Abstract
Background: Intestinal Obstruction is a frequent complication after operation for Ovarian Cancer. Thisstudy was done to see the outcome of palliative surgery for Intestinal Obstruction due to recurrentovarian Cancer. Methods: We retrospectively evaluated the records of all the patients who presentedwith intestinal obstruction after operations for Ovarian Cancer in all the three Surgical Units of AyubTeaching Hospital Abbottabad from March 1998 to April, 2009. Demographic data, type ofmanagement, morbidity, mortality, hospital stay, surgical procedure, symptomatic relief, return ofbowel function and outcome were analyzed. Results: There were 56 patients with symptoms of partialor complete intestinal obstruction. Conservative treatment was successful in 22 (39%) patients.Laparotomy was done in 30 (53.5%) patients. The cause of intestinal obstruction was adhesions 8(26.6%), local recurrence 10 (33.3%) and diffuse carcinomatosis in 12 (40%) patients. Palliativesurgery was done in 20 (66.6%) patients while 8 (26.6%) had adhesionolysis only. 9 (30%) patients hadresection and anastomosis, 7 (23.3%) had bypass surgery, 3 (10%) had colostomy and one (3%) hadHartmann procedure. Postoperative complications occurred in 26 (86.6%) patients. 12 (40 %) patientsdied after surgery. Mean hospital stay was 18 (9–42) days. Palliative surgery was successful in 8(26.65%). Conclusions: Majority of patients with Intestinal obstruction after operation for OvarianCancer can be managed conservatively. Palliative surgery is associated with high mortality andmorbidity but it should be done in patients not responding to conservative measures.Keywords: Ovarian cancer, Intestinal Obstruction, LaparotomyReferences
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