Recommendations for Bowel Obstruction With Peritoneal Carcinomatosis

This is a clinical practice guideline for patients who have bowel obstruction with advanced peritoneal carcinomatosis for which complete cytoreductive surgery and intraperitoneal hyperthermic chemoperfusion are no longer relevant. The guideline provides recommendations on clinical assessment and treatment options for relieving intestinal obstruction or its symptoms. Treatment/management options include surgery, steroids, stents, nasogastric tubes (NGT’s) and venting gastronomy, antisecretory drugs, and antiemetic management. Outcomes of interest include complication rate of surgical management (e.g. obstruction, perforation), morbi-mortality rates from surgery, and quality of life.