Abstract
Patients with unresectable cancer often need palliative surgery to improve the quality of life. However, there have been few reports that examined the outcomes of the palliative surgical procedures. The aim of the present study is to clarify the effectiveness of the palliative surgery. Data on 165 consecutive patients who underwent palliative surgery in our department of gastrointestinal surgery were retrospectively analyzed in terms of survival, mortality, and leaving hospital. Food-intake was also examined in patients with bowel obstruction. Origins of these cancers involved 23 organs, including the pancreas in 24 patients, the ovary in 23, the stomach in 22, and 20 other organs. Reasons for palliative surgery were as follows ; malignant bowel obstruction in 124 cases, malignant fistula in 22 cases, obstructive jaundice in 10 cases, intestinal bleeding in six cases and intestinal perforation in three cases. The median survival time after the palliative operation was 4.5 months and the 30-day mortality rate was 12.7%. The operation enabled 60.6% of the patients to be discharged from the hospital. Higher mortality rate (31% P=0.007) was noted in emergency operations compared to elective operations. Among the patients with malignant bowel obstruction, the operation allowed 74% of the patients to take solid diets. The rate of oral intake was lower in patients with gastric cancer (45% P=0.004) and in those with multiple obstructions (63%, P=0.003). Palliative surgery can improve quality of life of the patients with unresectable cancer. Sufficient informed consent should be obtained especially regarding the high mortality rate.
