Usefulness of Octreotide for Bowel Obstruction in Terminally Ill Patients

Natsuki Tokura, Hironori Kaneko*, Masaaki Itoh, Tatsuki Nanami, Ryoichi Honda, Masashi Watanabe* and Tatsuo Teramoto*

Department of Surgery, Saiseikai Wakakusa Hospital
Department of Surgery (Omori), Toho University School of Medicine*

Nausea, vomiting, and the feeling of abdominal distension due to bowel obstruction ruin a terminally ill patient's quality of life. Reports indicate that octreotide is effective against these symptoms. Octreotide was approved in an insurance adjustment in October 2004 when it became acceptable for use in general ward patients with bowel obstruction. We obtained excellent results using octreotide in seven terminally ill patients with bowel obstruction between May 2005 to March 2006. The four men and three women averaged 67.3±11.2 years of age. Primary cancer involved three gastric cancers, and one each of sigmoid colon cancer, ascending colon cancer, pancreatic cancer, and idiopathic cancer. Nausea, vomiting, and the feeling of abdominal distension were assessed based on efficacy criteria using the JCOG toxicity scale, and oral intake in five examples was attained. After using octreotide, none of the subjects required nasogastric tubes and hydration was decreased. Gastroenterological surgeons should thus consider the use of octreotide as the first choice in inoperable, terminally ill patients with bowel obstruction.

Key words
bowel obstruction, octreotide, terminally ill patient

Reprint requests
Natsuki Tokura Department of Surgery, Saiseikai Wakakusa Hospital
12-1 Hiragatamachi, Kanazawa-ku, Yokohama, 236-8653 JAPAN

Accepted
September 27, 2006

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