Objectives: This systematic review aimed to evaluate current surgical and non-surgical
management strategies for malignant bowel obstruction (MBO) in patients with gynaecological
cancer. Methods: Comprehensive literature searches were conducted across MEDLINE,
Embase, CENTRAL, and Scopus, without restrictions on language or publication date.
Following the removal of duplicates, 4866 articles were screened, with 34 meeting
the inclusion criteria. Results: Surgical intervention remains the definitive treatment
for MBO, offering longer symptom-free periods and improved survival, particularly
when conservative methods fail. However, the selection of surgical candidates is crucial
due to the high risk of morbidity and the potential for significant complications.
Non-surgical treatments, such as the use of Gastrografin, Octreotide, and Dexamethasone,
along with invasive procedures like nasogastric tubing, percutaneous gastrostomy,
and stent placement, offer varying degrees of symptom relief and are often considered
when surgery is not feasible. Conclusions: In this article we provide a potential
therapeutic algorithm for the management of patients with MBO. This review underscores
the urgent need for high-quality research to develop clear, evidence-based guidelines
for MBO management in patients with gynaecologic cancer. Establishing standardised
protocols will improve patient outcomes by aiding clinicians in making informed, individualised
treatment decisions.
