Transanal ileus catheter combined with nasal ileus catheter in the treatment of malignant ileus in 14 cases: a case series and literature review

Background: Malignant intestinal obstruction refers to intestinal obstruction caused by advanced primary tumors or secondary metastatic malignant tumors. Because surgical treatment cannot significantly improve the life cycle, non-surgical treatment is mostly used to improve the symptoms of intestinal obstruction; transanal intestinal obstruction catheter and transnasal intestinal obstruction catheter are palliative therapies for decompression and drainage. Transanal intestinal obstruction catheter is mostly used for rectal and left colon obstruction. Transnasal intestinal obstruction catheter is mostly used for small intestinal obstruction. The two catheters are generally used alone according to the site of obstruction and clinical manifestations, and there are few reports on the combined use of the two catheters. We try to use the two catheters to treat patients with complex conditions and explore a better treatment strategy for malignant intestinal obstruction.

Case description: Retrospective analysis From January 2016 to April 2022, 14 patients with advanced cancer were diagnosed as malignant intestinal obstruction by imaging data and clinical manifestations. Under the premise of no improvement in the symptoms of placement of a catheter, nasal ileus catheter combined with transanal ileus catheter was used for common decompression and drainage. The efficacy of combined catheterization was evaluated by comparing the differences in imaging data before and after catheterization, as well as analyzing the degree of relief and prognosis of intestinal obstruction symptoms; of intestinal obstruction symptoms was completely relieved in 4 of 14 patients combined catheterization, and spontaneous defecation and exhaust could be performed; intestinal obstruction symptoms were significantly relieved in 3 patients, reexamination of image air-fluid level was reduced by more than 70%, abdominal distension and abdominal pain were significantly relieved, and intermittent defecation and exhaust could be performed; intestinal obstruction symptoms were relieved in 3 patients, reexamination of image air-fluid level was reduced by 20-50%, abdominal distension and abdominal pain were relieved, and defecation and exhaust could not be performed; intestinal obstruction symptoms were not relieved in 4 patients.

Conclusions: Combined application of transanal ileus catheter and transnasal ileus catheter decompression and drainage can be used as a palliative treatment to relieve the symptoms of malignant ileus.