Objective: To determine the value of operation in patients with bowel
obstruction caused by recurrent abdominal cancer. Design: Retrospectiv
e case review. Setting: The University of Connecticut Health Center, F
armington. Patients: Ninety-eight patients admitted with a diagnosis o
f bowel obstruction and malignant neoplasm between November 1, 1987, a
nd June 30, 1995. Results: Data for 75 patients who developed a bowel
obstruction within 5 years of a malignant diagnosis were analyzed. For
ty-six patients (61%) were treated operatively and 29 (39%) were treat
ed nonoperatively. The operative group included 32 patients (70%) whos
e obstruction was caused by carcinomatosis; 6 (19%) of these 32 patien
ts had had at least 1 episode of previous obstruction requiring hospit
alization. They had a 22% in-hospital mortality, stayed an average of
21 days in the hospital, and survived 7+/-6 months (mean+/-SD) after d
ischarge; 5 (16%) had at least I episode of postoperative obstruction
that required hospitalization. After discharge from the hospital, 53%
had an excellent or good quality of life (assessed retrospectively). O
f the 29 patients in the nonoperative group, 16 (55%) had carcinomatos
is. These 16 patients had a 38% in-hospital mortality (6 of 16), staye
d an average of 10 days in the hospital, and survived a mean of 13+/-9
months; 3 (19%) had at least 1 episode of recurrent obstruction requi
ring hospitalization. After discharge from the hospital, 6 (37%) had a
n excellent or good quality of life. Conclusion: The value of operativ
e intervention for bowel obstruction in patients with cancer is derive
d from the possibility of a benign cause, not alleviation of the conse
quences of carcinomatosis.