Diagnosis and Treatment of Postoperative Intestinal Obstruction of Gastrointestinal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 TIANJun ^1,2 , YAOXue-quan ¹ ,  WUXiao-yu ¹ , CAOQin-hong ¹ , CHENChe ¹ , ZHOULiang ¹ , XUZhe ¹ , LIWei-su ¹ , LIUFu-kun ¹

1. Department of Surgical Oncology, Jiangsu Province Hospital of Traditional Chinese Medcine, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210029, Jiangsu Province, China;
2. Department of General Surgery, Zhangjiagang Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine, Zhangjiagang 215600, Jiangsu Province, China;

Corresponding author：

WUXiao-yu, Email: wuxiaoyu@medmail.cn

Keywords：

Gastrointestinal cancer; Intestinal obstruction; Tumor marker; PET-CT

DOI：

10.7507/1007-9424.20140241

Video：

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Objective To investigate the diagnosis, treatment, and prognosis of the postoperative intestinal obstruction of gastrointestinal cancer. Method The clinical data of 58 patients with postoperative intestinal obstruction of gastrointestinal cancer from January 2011 to January 2013 were analyzed retrospectively. Results In 58 patients with postoperative intestinal obstruction, there were 46 cases of incomplete intestinal obstruction, 12 cases of complete obstruction. Seventeen cases were treated conservatively and 41 cases were accepted laparotomy. The surgical exploration found that there were 4 cases of strangulated abdominal internal hernia, 4 cases of volvulus, 1 case of stercoral obstruction, 2 cases of intussusception, 9 cases of adhesive intestinal obstruction, and 21 cases of tumor recurrence. There were 32 patients with high tumor markers before laparotomy, including 19 cases of tumor recurrence. Fourteen cases had no obvious tumor lesions detected by PET-CT, but recurrence and metastasis were found by surgical exploration. Conclusions The recurrent postoperative intestinal obstruction of gastrointestinal cancer mostly means recurrence and metastasis, with poor prognosis. Early laparotomy may improve the prognosis and the quality of life, elevated tumor markers have some links with tumor recurrence and PET-CT is not sensitive for multiple nodular metastases.

Citation： TIANJun, YAOXue-quan, WUXiao-yu, CAOQin-hong, CHENChe, ZHOULiang, XUZhe, LIWei-su, LIUFu-kun. Diagnosis and Treatment of Postoperative Intestinal Obstruction of Gastrointestinal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(8): 1005-1008. doi: 10.7507/1007-9424.20140241 Copy

1.	黎介寿.认识术后早期炎症性肠梗阻的特性[J].中国实用外科杂志, 1998, 18(7): 387-388.
2.	马广友, 刘延锋.小肠粘连性肠梗阻术后复发及其影响因素的研究[J].山东医药, 2010, 50(48): 64-65.
3.	王李, 童卫东.术后肠梗阻的发生机制研究进展[J].中国普外基础与临床杂志, 2011, 18(10): 1114-1117.
4.	任建安, 李宁.深入认识术后炎性肠梗阻[J].中国实用外科杂志, 2009, 29(4): 285-286.
5.	Barmparas G, Branco BC, Schnüriger B, et al. The incidence and risk factors of post-laparotomy adhesive small bowel obstruction[J]. J Gastrointest Surg, 2010, 14(10): 1619-1628.
6.	Lu YY, Chen JH, Chien CR, et al. Use of FDG-PET or PET/CT to detect recurrent colorectal cancer in patients with elevated CEA: a systematic review and meta-analysis[J]. Int J Colorectal Dis, 2013, 28(8): 1039-1047.
7.	Guyot F, Faivre J, Manfredi S, et al. Time trends in the treatment and survival of recurrences from colorectal cancer[J]. Ann Oncol, 2005, 16(5): 756-761.
8.	Engarås B. Individual cutoff levels of carcinoembryonic antigen and CA242 indicate recurrence of colorectal cancer with high sensitivity[J]. Dis Colon Rectum, 2003, 46(3): 313-321.
9.	Laubert T, Bente V, Freitag-Wolf S, et al. Aneuploidy and elevated CEA indicate an increased risk for metachronous metastasis in colorectal cancer[J]. Int J Colorectal Dis, 2013, 28(6): 767-775.
10.	吴文辉, 肖隆斌, 杨世斌, 等.监测血清肿瘤标志物水平预测结肠癌根治术后复发或转移的意义[J/CD].消化肿瘤杂志:电子版, 2010, 2(2): 93-96.
11.	Chen LB, Tong JL, Song HZ, et al. (18)F-DG PET/CT in detection of recurrence and metastasis of colorectal cancer[J]. World J Gastroenterol, 2007, 13(37): 5025-5029.
12.	Schmidt GP, Baur-Melnyk A, Haug A, et al. Whole-body MRI at 1.5 T and 3 T compared with FDG-PET-CT for the detection of tumour recurrence in patients with colorectal cancer[J]. Eur Radiol, 2009, 19(6): 1366-1378.
13.	Chua SC, Groves AM, Kayani I, et al. The impact of 18F-FDG PET/CT in patients with liver metastases[J]. Eur J Nucl Med Mol Imaging, 2007, 34(12): 1906-1914.
14.	Shanmugan S, Arrangoiz R, Nitzkorski JR, et al. Predicting pathological response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer using 18FDG-PET/CT[J]. Ann Surg Oncol, 2012, 19(7): 2178-2185.
15.	Bellomi M, Rizzo S, Travaini LL, et al. Role of multidetector CT and FDG-PET/CT in the diagnosis of local and distant recurrence of resected rectal cancer[J]. Radiol Med, 2007, 112(5): 681-690.
16.	Wang Z, Chen JQ. Imaging in assessing hepatic and peritoneal metastases of gastric cancer: a systematic review[J]. BMC Gastroenterol, 2011, 11: 19.
17.	Pahlman L. Improved survival with preoperative radiotherapy in resectable rectal cancer[J]. N Engl J Med, 1997, 336(14): 179-182.
18.	Gérard JP, Conroy T, Bonnetain F, et al. Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3-4 rectal cancers: results of FFCD 9203[J]. J Clin Oncol, 2006, 24(28): 462-465.
19.	Greto D, Paiar F, Saieva C, et al. Neoadjuvant oxaliplatin and 5-fluorouracil with concurrent radiotherapy in patients with locally advanced rectal cancer: a single-institution experience[J]. Radiol Med, 2013, 118(4): 570-582.
20.	De Caluwé L, Van Nieuwenhove Y, Ceelen WP. Preoperative chemoradiation versus radiation alone for stageⅡandⅢresectable rectal cancer[J]. Cochrane Database Syst Rev, 2013, 2(2): CD006041.
21.	Marijnen CA, Nagtegaal ID, Klein Kranenbarg E, et al. No downstaging after short-term preoperative radiotherapy in rectal cancer patients[J]. J Clin Oncol, 2001, 19(7): 1976-1984.

1. 黎介寿.认识术后早期炎症性肠梗阻的特性[J].中国实用外科杂志, 1998, 18(7): 387-388.
2. 马广友, 刘延锋.小肠粘连性肠梗阻术后复发及其影响因素的研究[J].山东医药, 2010, 50(48): 64-65.
3. 王李, 童卫东.术后肠梗阻的发生机制研究进展[J].中国普外基础与临床杂志, 2011, 18(10): 1114-1117.
4. 任建安, 李宁.深入认识术后炎性肠梗阻[J].中国实用外科杂志, 2009, 29(4): 285-286.
5. Barmparas G, Branco BC, Schnüriger B, et al. The incidence and risk factors of post-laparotomy adhesive small bowel obstruction[J]. J Gastrointest Surg, 2010, 14(10): 1619-1628.
6. Lu YY, Chen JH, Chien CR, et al. Use of FDG-PET or PET/CT to detect recurrent colorectal cancer in patients with elevated CEA: a systematic review and meta-analysis[J]. Int J Colorectal Dis, 2013, 28(8): 1039-1047.
7. Guyot F, Faivre J, Manfredi S, et al. Time trends in the treatment and survival of recurrences from colorectal cancer[J]. Ann Oncol, 2005, 16(5): 756-761.
8. Engarås B. Individual cutoff levels of carcinoembryonic antigen and CA242 indicate recurrence of colorectal cancer with high sensitivity[J]. Dis Colon Rectum, 2003, 46(3): 313-321.
9. Laubert T, Bente V, Freitag-Wolf S, et al. Aneuploidy and elevated CEA indicate an increased risk for metachronous metastasis in colorectal cancer[J]. Int J Colorectal Dis, 2013, 28(6): 767-775.
10. 吴文辉, 肖隆斌, 杨世斌, 等.监测血清肿瘤标志物水平预测结肠癌根治术后复发或转移的意义[J/CD].消化肿瘤杂志:电子版, 2010, 2(2): 93-96.
11. Chen LB, Tong JL, Song HZ, et al. (18)F-DG PET/CT in detection of recurrence and metastasis of colorectal cancer[J]. World J Gastroenterol, 2007, 13(37): 5025-5029.
12. Schmidt GP, Baur-Melnyk A, Haug A, et al. Whole-body MRI at 1.5 T and 3 T compared with FDG-PET-CT for the detection of tumour recurrence in patients with colorectal cancer[J]. Eur Radiol, 2009, 19(6): 1366-1378.
13. Chua SC, Groves AM, Kayani I, et al. The impact of 18F-FDG PET/CT in patients with liver metastases[J]. Eur J Nucl Med Mol Imaging, 2007, 34(12): 1906-1914.
14. Shanmugan S, Arrangoiz R, Nitzkorski JR, et al. Predicting pathological response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer using 18FDG-PET/CT[J]. Ann Surg Oncol, 2012, 19(7): 2178-2185.
15. Bellomi M, Rizzo S, Travaini LL, et al. Role of multidetector CT and FDG-PET/CT in the diagnosis of local and distant recurrence of resected rectal cancer[J]. Radiol Med, 2007, 112(5): 681-690.
16. Wang Z, Chen JQ. Imaging in assessing hepatic and peritoneal metastases of gastric cancer: a systematic review[J]. BMC Gastroenterol, 2011, 11: 19.
17. Pahlman L. Improved survival with preoperative radiotherapy in resectable rectal cancer[J]. N Engl J Med, 1997, 336(14): 179-182.
18. Gérard JP, Conroy T, Bonnetain F, et al. Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3-4 rectal cancers: results of FFCD 9203[J]. J Clin Oncol, 2006, 24(28): 462-465.
19. Greto D, Paiar F, Saieva C, et al. Neoadjuvant oxaliplatin and 5-fluorouracil with concurrent radiotherapy in patients with locally advanced rectal cancer: a single-institution experience[J]. Radiol Med, 2013, 118(4): 570-582.
20. De Caluwé L, Van Nieuwenhove Y, Ceelen WP. Preoperative chemoradiation versus radiation alone for stageⅡandⅢresectable rectal cancer[J]. Cochrane Database Syst Rev, 2013, 2(2): CD006041.
21. Marijnen CA, Nagtegaal ID, Klein Kranenbarg E, et al. No downstaging after short-term preoperative radiotherapy in rectal cancer patients[J]. J Clin Oncol, 2001, 19(7): 1976-1984.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Treatment of Postoperative Intestinal Obstruction of Gastrointestinal Cancer

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