Combination of transnasal ileus tube and local small intestine artery perfusion chemotherapy for late malignant small bowel obstruction

Abstract

Abstract Objective Malignant bowel obstruction (MBO) caused by peritoneal carcinomatosis is a common complication of advanced abdominal malignancies, and surgical treatment provides little benefit. To investigate the decompression efficacy of transnasal ileus tube combined with local arterial infusion chemotherapy in the treatment of advanced malignant small intestine obstruction.Methods 109 patients diagnosed with malignant intestinal obstruction between January 2016 and December 2022 in our hospital were divided into the ileus tube + local infusion chemotherapy group (test group, n = 51) and the ileus tube group (control group, n = 58). The control group only received catheter decompression therapy, while the test group used ileus tube combined with local arterial infusion chemotherapy. The data on the technical success, initial and final angiographic results, GPS scores, KPS scores and the final clinical outcome were collected and follow-up was performed at 1-, 3-, 6-, 12-months, and yearly after the procedures.Results All patients had successful placement of the ileus tube and local infusion chemotherapy without complications. The average catheter duration in the test group was significantly lower than that of the control group (P < 0.05). The final clinical follow-up showed that the remission rate of intestinal obstruction symptoms in the test group was significantly higher than that of the control group (P < 0.05, 84.3% vs 22%), and the survival time of patients in the test group was significantly longer than that of the control group (P < 0.05). Finally, although the GPS and KPS scores of both groups decreased significantly after surgery, compared with the control group, the test group had a more significant decrease and significant differences at each follow-up period (P < 0.05).Conclusion Compared with ileus tube group, the ileus tube combined with local small bowel arterial infusion chemotherapy can effectively alleviate clinical symptoms of malignant small intestinal obstruction and prolong patients' survival time, which is worth promoting clinically.