Arterial-enteric fistula after pelvic lymphadenectomy in secondary cytoreductive surgery for recurrent ovarian cancer

J Obstet Gynaecol. 2019 Nov;39(8):1049-1056. doi: 10.1080/01443615.2019.1586856. Epub 2019 Jun 14.

Abstract

In 6.2% of gynaecologic malignancies, vascular involvement is reported. Cytoreductive surgery presents in those cases a higher rate of major complications. Arterial-enteric fistula is a very rare post-surgical complication with serious repercussions on the patient's life due to intestinal haemorrhage and the overlapping sepsis. This is the first case report about iliac-colonic fistula formation in recurrent ovarian cancer with lymph-node metastasis after laparoscopic secondary cytoreductive surgery in a 75-year-old woman and its successful surgical management. A literature review about arterial-enteric fistula formation in gynaecologic cancer treatment, specifically ovarian cancer, is also reported, hypothesising the risk factors of this severe postoperative complication and possible surgical solutions.

Keywords: Arterial-enteric fistula; cytoreductive surgery; lymphadenectomy; ovarian cancer; post-operative complication.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Colon / surgery
  • Cytoreduction Surgical Procedures
  • Female
  • Fistula / etiology*
  • Fistula / surgery
  • Humans
  • Iliac Artery* / surgery
  • Intestinal Fistula / etiology*
  • Intestinal Fistula / surgery
  • Lymph Node Excision / adverse effects*
  • Neoplasm Recurrence, Local / surgery*
  • Ovarian Neoplasms / surgery*
  • Postoperative Complications / etiology
  • Risk Factors
  • Tissue Adhesions / surgery