Gastrostomía descompresiva para pacientes con obstrucción intestinal maligna: serie de casos

Background: Malignant intestinal obstruction is a common oncological complication; it limits survival and impairs the quality of life of patients. Surgical management options are often more effective than medical strategies but carry a higher complication rate. Recent consensus proposes percutaneous decompressive gastrostomy as an alternative for refractory symptoms to medical management. Patients and methods: A retrospective observational case series study was conducted on patients with malignant intestinal obstruction who underwent decompressive gastrostomy with palliative intent, and were treated between the years 2015 and 2022 at the National Cancer Institute in Bogotá, Colombia. Patients were identified through the Universal Procedure Point Code registered in medical records and extracted from the oncology center’s database. For patients meeting inclusion criteria, sociodemographic, oncological, and clinical variables were documented by 2 investigators based on their medical records. Results: A total of 426 medical records were reviewed, revealing 3 patients diagnosed with malignant intestinal obstruction who underwent palliative surgical management with decompressive gastrostomy. The patients ranged in age from 27 to 43 years; all underwent open surgical procedures, and on average received palliative care assessment on the eleventh day after admission. They required an average dose of 73 mg of morphine equivalent per day, stayed hospitalized for a mean of 23 days, and succumbed approximately 14 days after the procedure. Conclusion: Malignant bowel obstruction is a complex pathology with high symptomatic burden. Decompressive gastrostomy is a rarely used procedure in the Global South that may be useful if performed promptly, percutaneously, in patients who want to be treated at home or whose symptoms are refractory to medical management.