{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T04:33:25Z","timestamp":1778474005476,"version":"3.51.4"},"reference-count":25,"publisher":"Royal College of Surgeons of England","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2021,11]]},"abstract":"Introduction<\/jats:title> Management of malignant small bowel obstruction (mSBO) is challenging. The decision to perform an operation evaluates the perceived chance of success against a patient\u2019s fitness for operation. The aim of this study was to characterise the mSBO patient population in a tertiary UK centre and assess the patient\u2019s treatment pathway including use and effects of palliative surgery, total parenteral nutrition (TPN), Gastrografin and dexamethasone as well as preoperative stratification. <\/jats:p><\/jats:sec>Methods<\/jats:title> Patients were included if they had mSBO confirmed on computed tomography imaging due to a primary or metastatic neoplasm. Data were collected on pathway and management, and Cox proportional hazard methods were utilised to observe effects on survival. <\/jats:p><\/jats:sec>Results<\/jats:title> Ninety-four patients were included, with 104 inpatient episodes. Mean age was 67.4 (SD 13.7), with 57 (60.6%) females. Most (89.4%) had only one admission for mSBO. Eighty-four (89.4%) patients died over the ten-year period, 18 (17.3%) within 30 days of admission. Fifty patients (53.1%) underwent operative management: 70% bypass, 24% stoma formation and 6% open-close laparotomies. Log rank testing of survival probability analysis was significant (p\u2009=\u20090.00018), with 50% survival probability at 107.32 days for operative management and 47.87 days for non-operative. <\/jats:p><\/jats:sec>Discussion and Conclusion<\/jats:title> Operative management forms part of the treatment pathway for a significant proportion of patients with mSBO, offering a survival benefit, though quality of survival is not known. Case selection is good, with few open-close laparotomies. Trials of non-operative interventions such as Gastrografin and dexamethasone are not utilised fully. <\/jats:p><\/jats:sec>","DOI":"10.1308\/rcsann.2021.0044","type":"journal-article","created":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T17:58:28Z","timestamp":1630000708000},"page":"738-744","source":"Crossref","is-referenced-by-count":5,"title":["A single-centre ten-year retrospective cohort study of malignant small bowel obstruction"],"prefix":"10.1308","volume":"103","author":[{"given":"LD","family":"Cato","sequence":"first","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Evans","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ST","family":"Ward","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"171","reference":[{"key":"C1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2013.08.022"},{"key":"C2","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S29297"},{"key":"C3","doi-asserted-by":"publisher","DOI":"10.1007\/s10354-019-00715-3"},{"key":"C4","doi-asserted-by":"publisher","DOI":"10.1002\/CAM4.587"},{"key":"C5","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012014.pub2"},{"key":"C6","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001219"},{"key":"C7","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20170036"},{"key":"C8","unstructured":"R Foundation for Statistical Computing. 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