Peritoneal carcinomatosis-associated malignant bowel obstruction is a common feature that merits more attention in advanced and recurrent ovarian cancer. Decompressive gastrostomy is one of the most preferred methods to palliate distressing symptoms and maintain patients’ quality of life. We retrospectively identified 31 patients with ovarian cancer-associated MBO, who underwent decompressive CT fluoroscopy-guided percutaneous gastrostomy (CT-PG) between September 2015 and April 2023 at our institution. A systematic literature review was conducted for CT-guided gastrostomy in ovarian cancer. Prior to CT-PG, 27 (87%) patients underwent unsuccessful attempts at endoscopic gastrostomy or surgery due to bowel obstruction; a total of 55% had received ≥3 lines of chemotherapy. CT-PG could be successfully inserted in 25 of 31 (81%) patients without grade 4–5 complications. CT-PG insertion was feasible in 76% of patients with previous unsuccessful attempts of endoscopic gastrostomy. A total of 80% of patients with a successful insertion had considerable symptom relief and could tolerate fluid intake. Mean survival after the procedure was 44.4 days. Chemotherapy could be administered in 7 of 25 (28%) patients following the CT-PG insertion. CT-guided percutaneous gastrostomy is a safe procedure that effectively manages intractable symptoms of bowel obstruction in ovarian cancer. This minimally invasive technique should be emphasised as a routine instrument within the palliative management of MBO.
腹膜癌病相关性恶性肠梗阻是晚期及复发性卵巢癌中值得更多关注的常见临床表现。减压性胃造口术是缓解痛苦症状、维持患者生活质量的首选方法之一。我们回顾性分析了2015年9月至2023年4月期间在本机构接受CT透视引导下经皮胃造口减压术（CT-PG）的31例卵巢癌相关恶性肠梗阻患者，并对卵巢癌CT引导胃造口术进行了系统性文献综述。在CT-PG实施前，27例（87%）患者因肠梗阻曾尝试内镜下胃造口术或外科手术未获成功；总计55%的患者接受过≥3线化疗。31例患者中25例（81%）成功置入CT-PG导管，未发生4-5级并发症。在既往内镜下胃造口术失败的病例中，76%的患者成功实施了CT-PG置入术。成功置管的患者中80%获得显著症状缓解并能耐受液体摄入。术后平均生存期为44.4天。25例患者中有7例（28%）在CT-PG置入后得以继续接受化疗。CT引导下经皮胃造口术是一种安全有效的操作技术，能显著改善卵巢癌患者肠梗阻的顽固症状。这一微创技术应作为恶性肠梗阻姑息治疗的常规手段予以重视。
肿瘤(癌症)患者之家