title: The utility of gastrojejunostomy in secondary cytoreduction and palliation of proximal intestinal obstruction in recurrent ovarian cancer.
abstract: BACKGROUND
  Gastrointestinal obstruction is a common complication of recurrent ovarian cancer. Proximal intestinal obstruction, at the level of the duodenum or proximal jejunum, can result from bulky intraperitoneal or retroperitoneal disease. Classic management has been palliation of symptoms with a gastrostomy or jejunostomy tube.
  
  
  METHODS
  We describe a series of four patients with recurrent ovarian carcinoma and proximal intestinal obstructions treated with a bypass stapled side-to-side gastrojejunostomy at the time of secondary cytoreduction or surgical palliation. The clinical history, preoperative evaluation, surgical technique, and outcomes of each patient are reviewed.
  
  
  CONCLUSIONS
  Gastrojejunostomy may offer patients with ovarian cancer and a proximal intestinal obstruction symptomatic relief and an opportunity for resumption of enteral feedings.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, 6900 Georgia Avenue NW, Washington, DC 20902, USA.
authors.forename: William E
authors.initials: WE
authors.lastname: Winter
authors.forename: John W
authors.initials: JW
authors.lastname: McBroom
authors.forename: Jay W
authors.initials: JW
authors.lastname: Carlson
authors.forename: G Scott
authors.initials: GS
authors.lastname: Rose
authors.forename: John C
authors.initials: JC
authors.lastname: Elkas
mesh_terms: D000368:Aged; D005260:Female; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery*; D007582:Jejunostomy / Q000379:methods*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications* / Q000601:surgery; D010166:Palliative Care; D016896:Treatment Outcome