{
  "abstract": "Background Malignant bowel obstruction (MBO) is a prevalent complication in advanced gastrointestinal and gynaecological cancers carrying a mean life expectancy of 4-5 weeks (Boland, Boland. Medicine. 2020;48(1):18-22). It can result in severe pain, nausea and bloating. Venting gastrostomies/jejunostomies are used to decompress the bowel to provide symptomatic relief, whilst total parenteral nutrition (TPN) provides adequate nutrient and fluid intake when oral intake is hindered.Aim To assess whether the combined intervention of total parenteral nutrition and venting gastrostomies impacts four outcomes: mood around food, quality of life, survival and improvement in symptoms.Method Eight databases were searched using terms including malignant bowel obstruction, gastrostomy, TPN, quality of life, survival, and symptoms. Broad inclusion criteria were applied, with no limits on date, text availability, or article type. Studies were included if patients had malignant bowel obstruction and received both interventions (TPN and VG/VJ). GRADE and GRADE-CERQual criteria were used for evaluation.Results A total of 520 patients across 14 studies were included. Quality of life was evaluated in 177 patients, with reported improvements. Survival outcomes in 265 patients demonstrated increased duration with combined TPN and VG therapy. One case series noted a survival extension of 728 days in a single patient receiving dual intervention (DeEulis, Yennurajalingam. J Palliat Med. 2015;18(8):722-8). A separate study (n=19) showed a statistically significant survival benefit (9.6 vs. 4.3 weeks, P<0.003) (Diver, O’Connor, Garrett, et al. Gynecol Oncol. 2013;129(2):332-5). Symptom improvement was noted in 75% of studies, with 25% of patients reporting symptomatic relief post-intervention (Campagnutta, Cannizzaro, Gallo, et al. Gynecol Oncol. 1996;62(1):103-5). One study examined psychosocial impacts, highlighting the emotional burden and social isolation associated with loss of oral intake (Sowerbutts, Lal, Sremanakova, et al. J Hum Nutr Diet. 2020;33(4):550-556).Conclusion This review found that TPN and VG/VJ may increase survival in patients with malignant bowel obstruction. Symptomatic relief suggests potential quality of life benefits, though current data remain limited and subjective. The importance of a holistic approach, including psychosocial factors, was highlighted.",
  "authors": [
    {
      "affiliations": [
        "University Hospital Coventry and Warwickshire, Coventry, UK"
      ],
      "name": "Mashal Qureshi"
    }
  ],
  "title": "P-68 Does the dual intervention of parenteral nutrition and venting gastrostomies/jejunostomies in patients with malignant bowel obstruction improve quality of life?",
  "uid": "b3702fa4-3151-534b-854d-0432aabb11c7"
}