M Fournier1, C Huchon2, C Ngo3, C Bensaid4, A S Bats5, P Combe6, M A le FrèreBelda7, L Fournier8, A Berger9, F Lecuru5. 1. Gynecologic Oncology, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France. Electronic address: fourniermarie8586@gmail.com. 2. Obstetrics and Gynecology Department, CHI Poissy-St-Germain, Université Versailles- Saint-Quentin en Yvelines, Poissy, France; EA 7285, Risques Cliniques et Sécurité en Santé des Femmes, Université Versailles-Saint- Quentin en Yvelines, Versailles, France. 3. Gynecologic Oncology, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France; Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; UMR S 1124, Faculté de Médecine, Université Paris Descartes, Paris, France. 4. Gynecologic Oncology, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France. 5. Gynecologic Oncology, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France; Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; ARCAGY-GINECO, Hôpital Hôtel Dieu, 1 parvis Notre Dame, 75004, Paris, France; UMR S 1124, Faculté de Médecine, Université Paris Descartes, Paris, France. 6. Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; ARCAGY-GINECO, Hôpital Hôtel Dieu, 1 parvis Notre Dame, 75004, Paris, France; Medical Oncology, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France. 7. Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Pathology Department, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France. 8. Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Imaging Department, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France. 9. Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; General and Digestive Surgery, Hôpital Européen Georges Pompidou, APHP, Paris, France.
Abstract
AIM: Rectosigmoid resection is often performed during cytoreductive surgery for ovarian cancer, to achieve the goal of no residual tumour. Here, we evaluated the morbidity associated with rectosigmoid resection and the underlying risk factors. METHODS: We retrospectively assessed consecutive patients managed with rectosigmoid resection during cytoreductive surgery for ovarian cancer at our centre in Paris, France, between 2005 and 2013. All previously identified risk factors were analysed. Major complications were defined as grade III-IV in the Clavien-Dindo classification. RESULTS: Of 228 patients, 116 had primary and 112 interval surgery; 43/228 [18.9%]; experienced major complications, and these were more common after primary surgery [24.1% vs. 13.4%, p = .04]. The 69 patients who had rectosigmoid resection [33 primary vs. 36 interval surgery, p = .32] had a higher morbidity rate compared to the other patients [30.4% vs. 14.6%, p = .006]. The anastomotic leakage rate was 2.89%. By multivariate logistic regression, independent risk factors for morbidity were postmenopausal status [adjusted odds ratio (aOR), 13.7; 95% confidence interval (95%CI), 1.2;161.9], surgery after neoadjuvant chemotherapy [aOR, 4.4; 95%CI, 1.1;18.8], and peritoneal stripping of the left; paracolic gutter [aOR, 11.3; 95%CI, 2.3;54.3]. CONCLUSION: The morbidity of rectosigmoid resection during cytoreductive surgery for ovarian cancer seems acceptable. Ileostomy does not seem associated with a lower risk of major complications or adjuvant bevacizumab with a higher complication rate.
AIM: Rectosigmoid resection is often performed during cytoreductive surgery for ovarian cancer, to achieve the goal of no residual tumour. Here, we evaluated the morbidity associated with rectosigmoid resection and the underlying risk factors. METHODS: We retrospectively assessed consecutive patients managed with rectosigmoid resection during cytoreductive surgery for ovarian cancer at our centre in Paris, France, between 2005 and 2013. All previously identified risk factors were analysed. Major complications were defined as grade III-IV in the Clavien-Dindo classification. RESULTS: Of 228 patients, 116 had primary and 112 interval surgery; 43/228 [18.9%]; experienced major complications, and these were more common after primary surgery [24.1% vs. 13.4%, p = .04]. The 69 patients who had rectosigmoid resection [33 primary vs. 36 interval surgery, p = .32] had a higher morbidity rate compared to the other patients [30.4% vs. 14.6%, p = .006]. The anastomotic leakage rate was 2.89%. By multivariate logistic regression, independent risk factors for morbidity were postmenopausal status [adjusted odds ratio (aOR), 13.7; 95% confidence interval (95%CI), 1.2;161.9], surgery after neoadjuvant chemotherapy [aOR, 4.4; 95%CI, 1.1;18.8], and peritoneal stripping of the left; paracolic gutter [aOR, 11.3; 95%CI, 2.3;54.3]. CONCLUSION: The morbidity of rectosigmoid resection during cytoreductive surgery for ovarian cancer seems acceptable. Ileostomy does not seem associated with a lower risk of major complications or adjuvant bevacizumab with a higher complication rate.
Authors: Alexandros Laios; Raissa Vanessa De Oliveira Silva; Daniel Lucas Dantas De Freitas; Yong Sheng Tan; Gwendolyn Saalmink; Albina Zubayraeva; Racheal Johnson; Angelika Kaufmann; Mohammed Otify; Richard Hutson; Amudha Thangavelu; Tim Broadhead; David Nugent; Georgios Theophilou; Kassio Michell Gomes de Lima; Diederick De Jong Journal: J Clin Med Date: 2021-12-24 Impact factor: 4.241
Authors: Blair McNamara; Rosa Guerra; Jennifer Qin; Amaranta D Craig; Lee-May Chen; Madhulika G Varma; Jocelyn S Chapman Journal: Gynecol Oncol Rep Date: 2021-09-25