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. 2016 Jan 4;2016(1):CD002764. doi: 10.1002/14651858.CD002764.pub2

Kolomainen 2012.

Methods Retrospective review
Participants 90 women with relapsed epithelial ovarian cancer who underwent palliative surgery for bowel obstruction 1992 to 2008: both elective and emergency (surgery within 24 hours of decision to operate)
Interventions Gastrostomy 19/90 (alone 15/90, as part of procedure 4/90); bypass +/‐ stoma 5/90; stoma 56/90; anastomosis 17/90; bowel resection 22/90
No conservative treatment
Outcomes "Successful palliation" as independent of IV fluids and adequate oral intake at 60 days postoperative: overall 66% (59/90); emergency 69% (34/49); elective 63% (25/40)
Postoperative mortality: overall 18% (16/90); emergency 20% (10/49); elective 15% (6/40)
Postoperative morbidity rate: 27% (24/90); return to operating room 2/90; high‐output stoma 9/90; retraction of stoma 3/90; parastomal abscess 1/90; superficial wound breakdown 2/90; wound infection 3/90; wound dehiscence 2/90; prolonged ileus 1/90; intra‐abdominal/sub‐sheath collections 1/90; medical complications 5/90
Median overall survival: 90.5 days (< 1 day to 6 years)
Re‐obstruction rate: 10 patients further obstructed and no further surgery
Notes Unclear outcome 1 patient
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) High risk No allocation. All patients included in study underwent surgery. "Indication of surgery was based on clinical findings of an acute abdomen, failure of bowel obstruction to resolved following a period of conservative management."
Allocation concealment (selection bias) High risk No blinding. All patients included in study underwent surgery. Outcomes identified from review of notes made by clinicians at time of treatment
Blinding (performance bias and detection bias) 
 All outcomes High risk No blinding. All patients included in study underwent surgery. Outcomes identified from review of notes made by clinicians at time of treatment
Blinding of participants and personnel (performance bias) 
 All outcomes High risk No blinding. All patients included in study underwent surgery. Outcomes identified from review of notes made by clinicians at time of treatment
Blinding of outcome assessment (detection bias) 
 All outcomes High risk No blinding. All patients included in study underwent surgery. Outcomes identified from review of notes made by clinicians at time of treatment
Selective reporting (reporting bias) Unclear risk Unclear outcome 1 patient
Results not reported according to surgical intervention
Symptoms not included in "successful palliation"