Abstract
Purpose: Gastrointestinal bypass may not always allow the patients who have gastrointestinal obstruction associated with unresectable cancer to improve their tolerance of diet. We evaluated effects of surgical bypass and discussed its indication. Methods: Thirty consecutive patients who underwent palliative gastrointestinal bypass for unresectable cancer were eligible for inclusion in this study. We investigated periods of tolerance or intolerance of diet, and calculated a ratio of improvement of food intake which is a proportion of the period of tolerance of diet after surgical bypass to that of intolerance until death. Results: The mean ratio of improvement of food intake was 41%. The ratio of less than 5% was observed in one of the nine patients with gastric cancer, 5 of the 12 patients with pancreaticobiliary cancer, 1 of the 2 urinary cancer patients, and none of the 7 colon cancer patients. Conclusion: The results have suggested that gastrointestinal bypass may improve tolerance of diet for the patient with gastrointestinal obstruction in approximately 40% of the period of his/her terminal stage. The ratio of improvement of food intake is different depending on the primary cancer site. Further investigation may be needed to determine its indication in patients with gastrointestinal obstruction associated with unresectable cancer. Palliat Care Res 2009; 4(2): 235-239.
