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Surgical versus non-surgical management for patients with malignant bowel obstruction (S1316): a pragmatic comparative effectiveness trial.

Krouse RS, Anderson GL, Arnold KB, Thomson CA, Nfonsam VN, Al-Kasspooles MF et al.

Lancet Gastrohepatol 2023; 8: 908-919.

This study included 199 patients with end-stage malignancy, only 49 agreed to be randomized. Surgery did not reduce did not improve the number of days alive and out of hospital over the next 91 days: 42 versus 43 days, P=0.5. Respective outcomes in the non-randomized group were 54 and 52 days

Comment: Fascinating study of a complex and difficult problem. But surgery seems to play no part. Possibly a plea for enhanced palliative care?

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