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• W79748459 abstract "alignant bowel obstruction is a common clinical complication in patients with ad-vanced abdominal or pelvic malignancy, such as colonic, ovarian, or gastric cancer [1, 2]. Extra-abdominal cancers such as lung, breast, and melanoma can also spread to the abdomen, caus-ing secondary bowel obstruction. The frequency of bowel obstruction in patients with advanced ovar-ian cancer ranges from 5% to 42% and in patients with advanced colorectal cancer, from 4% to 24% [3–13]. Nausea, vomiting, and continuous and/or colicky pain are the most frequent gastrointestinal (GI) symptoms of bowel obstruction.The management of patients with malignant bowel obstruction is one of the greatest challenges for physicians who treat patients with cancer. Al-though surgery remains the treatment of choice and should be considered in all cases of bowel ob-struction, there are absolute contraindications to surgery in some patients. These contraindications include the results of a previous laparotomy dem-onstrating that corrective surgery is not possible, the presence of re-obstruction, intra-abdominal carcinomatosis, diffuse intra-abdominal tumors or multiple palpable masses, poor nutritional status, poor general performance status, a large volume of ascites, and, of course, the refusal of the patient to undergo surgery [14–16].In the face of a clearly incurable and inoperable situation, relief of a patient’s significant discomfort and suffering must be balanced with the need to simplify the care of a patient with a short life ex-pectancy. Placement of a nasogastric tube to drain secretions is not justified for symptom control in advanced and terminal cancer patients with in-operable obstruction because of the great distress the tube causes. Furthermore, this tube placement may create further complications, such as nasal or pharyngeal irritation, nasal cartilage erosion, oc-clusion necessitating flushing or replacement, and spontaneous expulsion [17].Several authors have studied and confirmed the efficacy of pharmacologic treatment of symp-toms (nausea, vomiting, and pain) in patients with inoperable bowel obstruction [6, 12, 14, 15, 18–28]. Pharmacologic therapy consists of analgesics (opioids and non-opioids), antisecretory drugs (oc-treotide [Sandostatin], scopolamine butylbromide or hydrobromide, and glycopyrrolate), and anti-emetics. Figure 1 summarizes the pharmacologic approach for such symptom management [15].The aims of this paper are to review the roles of octreotide in the perioperative management of bowel obstruction, in the control of GI symptoms due to inoperable bowel obstruction in patients with advanced and terminal cancer, and in revers-ing intestinal transit." @default.
• W79748459 created "2016-06-24" @default.
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• W79748459 date "2004-09-11" @default.
• W79748459 modified "2023-09-23" @default.
• W79748459 title "How to use octreotide for malignant bowel obstruction." @default.
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