OBJECTIVES: Anastomotic leak after recto-sigmoid (RS) resection for ovarian cancer (OC) is a life-threatening complication. Selection of patients for protective diverting stomas has been based on observations from the colorectal literature. Our objective was to identify primary risk factors for anastomotic leak in OC patients undergoing RS resection to better determine who would most benefit from protective diversion. METHODS: All patients with OC or primary peritoneal cancer who underwent a debulking procedure with RS resection between January 1999 and December 2004 were included. Retrospective chart review including review of operative notes, pathology reports, and medical records including follow-up visits was done. Cases with inadequate postoperative follow-up, primary end colostomies, or diverting stomas were excluded. RESULTS: 177 patients form our study cohort. There were a total of 12/177 anastomotic leaks (6.8%). The mean time to diagnosis of anastomotic leak was 19 days (range 4-32). The leak rate for primary debulking operations was 8.7% (10/115), whereas the leak rate in secondary debulking procedures was 3.2% (2/62) (NS, P = 0.22). In univariate analysis, only perioperative serum albumin was significantly associated with an increased risk of anastomotic leak (mean 3.4 g/dL vs. 2.4 g/dL, P = 0.002). Based on serum albumin, the leak rate was 6/29 (21%) for levels <3.0 g/dL and 2/58 (3.4%) for patients with albumin greater than or equal to 3.0 g/dL (OR 7.3, 95% CI 1.37-38.87). CONCLUSIONS: Low serum albumin is associated with an increased risk of anastomotic leak after RS resection for OC. Patients with a low albumin level may benefit from a protective diverting colostomy/ileostomy.
OBJECTIVES:Anastomotic leak after recto-sigmoid (RS) resection for ovarian cancer (OC) is a life-threatening complication. Selection of patients for protective diverting stomas has been based on observations from the colorectal literature. Our objective was to identify primary risk factors for anastomotic leak in OC patients undergoing RS resection to better determine who would most benefit from protective diversion. METHODS: All patients with OC or primary peritoneal cancer who underwent a debulking procedure with RS resection between January 1999 and December 2004 were included. Retrospective chart review including review of operative notes, pathology reports, and medical records including follow-up visits was done. Cases with inadequate postoperative follow-up, primary end colostomies, or diverting stomas were excluded. RESULTS: 177 patients form our study cohort. There were a total of 12/177 anastomotic leaks (6.8%). The mean time to diagnosis of anastomotic leak was 19 days (range 4-32). The leak rate for primary debulking operations was 8.7% (10/115), whereas the leak rate in secondary debulking procedures was 3.2% (2/62) (NS, P = 0.22). In univariate analysis, only perioperative serum albumin was significantly associated with an increased risk of anastomotic leak (mean 3.4 g/dL vs. 2.4 g/dL, P = 0.002). Based on serum albumin, the leak rate was 6/29 (21%) for levels <3.0 g/dL and 2/58 (3.4%) for patients with albumin greater than or equal to 3.0 g/dL (OR 7.3, 95% CI 1.37-38.87). CONCLUSIONS: Low serum albumin is associated with an increased risk of anastomotic leak after RS resection for OC. Patients with a low albumin level may benefit from a protective diverting colostomy/ileostomy.
Authors: Edward J Tanner; Olga T Filippova; Ginger J Gardner; Kara C Long Roche; Yukio Sonoda; Oliver Zivanovic; Mary Fischer; Dennis S Chi Journal: Gynecol Oncol Date: 2018-10-16 Impact factor: 5.482
Authors: Jamie N Bakkum-Gamez; Carrie L Langstraat; Janice R Martin; Maureen A Lemens; Amy L Weaver; Sumer Allensworth; Sean C Dowdy; William A Cliby; Bobbie S Gostout; Karl C Podratz Journal: Gynecol Oncol Date: 2012-02-24 Impact factor: 5.482
Authors: Robert A Burger; Mark F Brady; Michael A Bookman; Bradley J Monk; Joan L Walker; Howard D Homesley; Jeffrey Fowler; Benjamin E Greer; Matthew Boente; Gini F Fleming; Peter C Lim; Stephen C Rubin; Noriyuki Katsumata; Sharon X Liang Journal: J Clin Oncol Date: 2014-03-17 Impact factor: 44.544
Authors: Eleftheria Kalogera; Sean C Dowdy; Andrea Mariani; Giovanni Aletti; Jamie N Bakkum-Gamez; William A Cliby Journal: Gynecol Oncol Date: 2012-05-20 Impact factor: 5.482
Authors: S K Allensworth; C L Langstraat; J R Martin; M A Lemens; M E McGree; A L Weaver; S C Dowdy; K C Podratz; J N Bakkum-Gamez Journal: Gynecol Oncol Date: 2013-06-05 Impact factor: 5.482
Authors: Jill H Tseng; Rudy S Suidan; Oliver Zivanovic; Ginger J Gardner; Yukio Sonoda; Douglas A Levine; Nadeem R Abu-Rustum; William P Tew; Dennis S Chi; Kara Long Roche Journal: Gynecol Oncol Date: 2016-06-04 Impact factor: 5.482
Authors: Eleftheria Kalogera; Sean C Dowdy; Andrea Mariani; Amy L Weaver; Giovanni Aletti; Jamie N Bakkum-Gamez; William A Cliby Journal: Gynecol Oncol Date: 2013-04-08 Impact factor: 5.482