Surgical outcomes of mechanical intestinal obstruction due to neoplasms at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Background: Mechanical intestinal obstruction (IO)c due to neoplasms is associated with high morbidity and mortality rates worldwide. High rates of advanced stage cancers upon presentation in a resource-limited settings result in increased rates of IO, but the outcomes following surgical management are unknown. There was need to assess the surgical outcomes in our set up. Objective of the study was to assess the surgical outcomes of mechanical intestinal obstruction due to neoplasms in adults. Methods: We conducted a prospective, mixed-methods study utilizing data forms and patient interviews. We enrolled patients through census sampling from January to December 2023. Categorical data was summarized as frequencies and their corresponding percentages while the numerical data was summarized as means and standard deviation. Bivariate analysis was used to determine variable associations. Results: 59 patients were enrolled in the study, with an average age of 51 years and 64.4% being male. The tumor size (T) of T4 was the most common presentation (83%, n=49) with nodal involvement (77.9%, n=46) and metastatic (57.6%, n=34). The most common surgical intervention offered was creation of a diversion stoma (57.6%, n=34). The commonest postoperative complication was the surgical site infection (28.7%, n=29). The median length of hospital stay was 10 days. Moderately differentiated malignant neoplasms and large bowel obstruction were associated with higher risk of developing complications (p<0.001). The 30-day postoperative mortality rate was 10.8%. Conclusions: Majority of the neoplasms causing acute mechanical intestinal obstruction in adults were large bowel adenocarcinomas presenting at advanced stages.