Absolute contraindications Patient refusal Functional obstruction Ascites requiring frequent paracentesis Obstruction at multiple sites

Relative contraindications Poor performance status Patient > 65 y old with cachexia Albumin level < 25 g/L Metastatic cancer with poor symptom control Palpable abdominal masses or diffuse carcinomatosis Preoperative weight loss > 9 kg Previous radiotherapy to abdomen or pelvis Extensive previous chemotherapy or radiotherapy

Data from Kolomainen and Barton,¹ Soriano and Davis,⁵ and Roeland and von Gunten.⁸