Objective  We aimed to evaluate the efficacy of endoscopic transnasal intestinal obstruction catheter placement to alleviate malignant bowel obstruction (MBO) secondary to gynecologic malignancies, and to identify factors associated with treatment outcomes.

Methods  A retrospective cohort study was conducted using the clinical data of 50 patients with MBO secondary to gynecological malignancies who underwent endoscopic transnasal intestinal decompression catheter placement at Fujian Cancer Hospital between August 2022 and July 2025. We compiled comprehensive data encompassing patient age, tumor type, prior treatment regimens, history of abdominal surgeries, catheter placement status, pre-procedural laboratory parameters, and clinical efficacy outcomes.

Results Catheter placement was successful for all 50 patients. Among this group, 39 patients achieved clinical remission, while 11 did not. Among the latter, 5 discontinued treatment and 6 proceeded to surgery. Comparisons of clinical remission and non-remission groups revealed no significant differences in white blood cell count, albumin levels, or catheter insertion depth (all P>0.05), whereas a significant difference in platelet/lymphocyte ratio (PLR; P=0.006) was observed. Patients in the clinical non-remission group predominantly exhibited elevated procalcitonin (PCT) levels.

Conclusions Transnasal intestinal obstruction catheters can provide a safe and effective palliative option for MBO secondary to gynecologic malignancies, with its therapeutic efficacy significantly associated with tumor burden, PLR, and PCT levels.