Safety and Efficacy of Low Anterior en Bloc Resection as Part of Cytoreductive Surgery for Patients with Ovarian Cancer

Objective. To examine the feasibility and safety of a low anterior resection of the rectosigmoid plus adjacent pelvic tumour as part of primary cytoreduction for ovarian cancer. Methods. This study included 65 consecutive patients with primary ovarian cancer who had debulking surgery from 1996 throu...

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Published in:	Gynecologic oncology Vol. 83; no. 1; pp. 115 - 120
Main Authors:	Obermair, Andreas, Hagenauer, Sabine, Tamandl, Dietmar, Clayton, Rick D., Nicklin, James L., Perrin, Lewis C., Ward, Bruce G., Crandon, Alex J.
Format:	Journal Article Conference Proceeding
Language:	English
Published:	San Diego, CA Elsevier Inc 01-10-2001 Elsevier
Subjects:	Adult Aged Aged, 80 and over Anastomosis, Surgical - adverse effects Anastomosis, Surgical - methods Biological and medical sciences Colostomy - adverse effects Colostomy - methods complications cytoreduction Female Gynecologic Surgical Procedures - adverse effects Gynecologic Surgical Procedures - methods Humans low anterior rectal resection Medical sciences Middle Aged morbidity mortality ovarian cancer Ovarian Neoplasms - surgery Rectum - surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the genital tract and mammary gland Tropical medicine Australia Oceania mortality cytoreduction low anterior rectal resection complications morbidity ovarian cancer Human Mortality Cytoreduction Surgical resection Malignant tumor Statistical study Morbidity Female genital diseases Ovarian diseases Ovary Surgery Female Advanced stage Proctocolectomy
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Summary:	Objective. To examine the feasibility and safety of a low anterior resection of the rectosigmoid plus adjacent pelvic tumour as part of primary cytoreduction for ovarian cancer. Methods. This study included 65 consecutive patients with primary ovarian cancer who had debulking surgery from 1996 through 2000. All patients underwent an en bloc resection of ovarian cancer and a rectosigmoid resection followed by an end-to-end anastomosis. Parameters for safety and efficacy were considered as primary statistical endpoints for the aim of this analysis. Results. Postoperative residual tumour was nil, <1 cm, and >1 cm in 14, 34, and 14 patients, respectively. The median postoperative hospital stay was 11 days (range, 6 to 50 days). Intraoperative complications included an injury to the urinary bladder in one patient. Postoperative complications included wound complications (n = 14, 21.5%), septicemia (n = 9, 13.8%), cardiac complications (n = 7, 10.8%), thromboembolic complications (n = 5, 7.7%), ileus (n = 2, 3.1%), anastomotic leak (n = 2, 3.1%), and fistula (n = 1, 1.5%). Reasons for a reoperation during the same admission included repair of an anastomotic leak (n = 1), postoperative hemorrhage (n = 1), and wound debridement (n = 1). Wound complications, septicemia, and anastomotic leak formation were more frequent in patients who had a serum albumin level of ≤30 g/L preoperatively. There was one surgically related mortality in a patient who died from a cerebral vascular accident 2 days postoperatively. Conclusions. An en bloc resection as part of primary cytoreductive surgery for ovarian cancer is effective and its morbidity is acceptably low.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0090-8258 1095-6859
DOI:	10.1006/gyno.2001.6353