Joo-Hyuk Son1, Jeeyeon Kim2, Jinhyung Shim2, Tae-Wook Kong1, Jiheum Paek1, Suk-Joon Chang3, Hee-Sug Ryu1. 1. Division of Gynecologic Oncology, Ajou University School of Medicine, Suwon, Republic of Korea; Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea. 2. Division of Gynecologic Oncology, Ajou University School of Medicine, Suwon, Republic of Korea. 3. Division of Gynecologic Oncology, Ajou University School of Medicine, Suwon, Republic of Korea; Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: drchang@ajou.ac.kr.
Abstract
OBJECTIVE: The aim of this study was to evaluate the clinical outcomes of close rectal dissection (CRD) compared with those of total mesorectal excision (TME) as the posterior rectal dissection procedure during rectosigmoid colectomy performed as part of cytoreductive surgery in patients with epithelial ovarian cancer. METHODS: We retrospectively reviewed the medical records of 163 patients who underwent posterior rectal dissection for rectosigmoid resection, including low anterior resection or subtotal colectomy, as part of ovarian cancer surgery from 2006 to 2018. The TME technique was mainly performed by colorectal surgeons, and the CRD technique preserving the mesorectal tissue was performed by an experienced gynecologic oncology surgeon. The patients were divided into the TME group and the CRD group, and their clinical outcomes were analyzed. RESULTS: A total of 163 patients with ovarian cancer underwent rectosigmoid colon resection. Among the patients, 87 (53.4%) underwent CRD and 76 (46.6%) underwent TME as the posterior rectal dissection technique. The disease severity according to FIGO stage (p = .390) and the residual disease status (p = .412) were not statistically different between the 2 groups. However, the postoperative incidences of anastomotic leakage (p = .045) and prolonged ileus (>7 days, p = .055) were higher in the TME group. The pelvic recurrence rate and progression-free survival did not differ between the 2 groups (p = .663 and .790, respectively). CONCLUSIONS: Considering the perioperative outcomes, CRD may be an alternative technique for rectal dissection in ovarian cancer with less perioperative morbidity and equivalent oncologic outcomes.
OBJECTIVE: The aim of this study was to evaluate the clinical outcomes of close rectal dissection (CRD) compared with those of total mesorectal excision (TME) as the posterior rectal dissection procedure during rectosigmoid colectomy performed as part of cytoreductive surgery in patients with epithelial ovarian cancer. METHODS: We retrospectively reviewed the medical records of 163 patients who underwent posterior rectal dissection for rectosigmoid resection, including low anterior resection or subtotal colectomy, as part of ovarian cancer surgery from 2006 to 2018. The TME technique was mainly performed by colorectal surgeons, and the CRD technique preserving the mesorectal tissue was performed by an experienced gynecologic oncology surgeon. The patients were divided into the TME group and the CRD group, and their clinical outcomes were analyzed. RESULTS: A total of 163 patients with ovarian cancer underwent rectosigmoid colon resection. Among the patients, 87 (53.4%) underwent CRD and 76 (46.6%) underwent TME as the posterior rectal dissection technique. The disease severity according to FIGO stage (p = .390) and the residual disease status (p = .412) were not statistically different between the 2 groups. However, the postoperative incidences of anastomotic leakage (p = .045) and prolonged ileus (>7 days, p = .055) were higher in the TME group. The pelvic recurrence rate and progression-free survival did not differ between the 2 groups (p = .663 and .790, respectively). CONCLUSIONS: Considering the perioperative outcomes, CRD may be an alternative technique for rectal dissection in ovarian cancer with less perioperative morbidity and equivalent oncologic outcomes.
Authors: Barbara Costantini; Virginia Vargiu; Francesco Santullo; Andrea Rosati; Matteo Bruno; Valerio Gallotta; Claudio Lodoli; Rossana Moroni; Fabio Pacelli; Giovanni Scambia; Anna Fagotti Journal: Ann Surg Oncol Date: 2022-04-18 Impact factor: 4.339
Authors: Suk Joon Chang; Christina Fotopoulou; Robert E Bristow; Dennis S Chi; William A Cliby Journal: J Gynecol Oncol Date: 2021-05 Impact factor: 4.401