Goto 2012.

Methods	Retrospective review
Participants	53 patients with gynaecological malignancy and malignant bowel obstruction due to disease progression or recurrence between 2005 and 2010 Excluded: "cases with symptoms of bowel obstruction which were temporary and restorable with short medical treatment were excluded"
Interventions	33 patients pharmacological treatment 20 patients laparotomy: colostomy 11; ileostomy 7; bypass 7
Outcomes	Successful palliation defined as: ability to eat solid food for at least 60 days Surgical group: achieved 70% (14/20); symptoms unrelieved 10% (2/20) Postoperative complications 35% (7/20): infections and wound dehiscence 15% (3/20); abscess 20% (4/20); sepsis 5% (1/20); DVT 5% (1/20); short bowel syndrome 5% (1/20) Postoperative mortality within 30 days: 5% (1/20) Median survival following diagnosis of MBO operative: 146 days (61 to 294) Median survival following diagnosis of MBO non‐operative: 69 days
Notes	Operative group selected as fit for surgery and did better
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	"Of all the patients with gynaecological malignancy treated at our institute, medical records of patients who presented with MBO due to disease progression or recurrence between 2005 and 2010 were reviewed."
Allocation concealment (selection bias)	High risk	"Of all the patients with gynaecological malignancy treated at our institute, medical records of patients who presented with MBO due to disease progression or recurrence between 2005 and 2010 were reviewed."
Blinding (performance bias and detection bias) All outcomes	High risk	"Of all the patients with gynaecological malignancy treated at our institute, medical records of patients who presented with MBO due to disease progression or recurrence between 2005 and 2010 were reviewed."
Blinding of participants and personnel (performance bias) All outcomes	High risk	"Of all the patients with gynaecological malignancy treated at our institute, medical records of patients who presented with MBO due to disease progression or recurrence between 2005 and 2010 were reviewed."
Blinding of outcome assessment (detection bias) All outcomes	High risk	"Of all the patients with gynaecological malignancy treated at our institute, medical records of patients who presented with MBO due to disease progression or recurrence between 2005 and 2010 were reviewed."
Selective reporting (reporting bias)	Unclear risk	All patient outcomes reported for surgical group Conservative treatment group data limited Results not reported according to surgical intervention