Efficacy of Transanal Drainage Tube Placement After Modified Posterior Pelvic Exenteration for Primary Ovarian Cancer

Int J Gynecol Cancer. 2018 Feb;28(2):220-225. doi: 10.1097/IGC.0000000000001159.

Abstract

Objective: The aim of this study was to investigate the clinical usefulness of the placement of a transanal drainage tube (TDT) to prevent anastomotic leakage after a modified posterior pelvic exenteration (MPPE) for the treatment of primary ovarian cancer.

Methods: We performed a retrospective review of all the consecutive patients who had undergone an MPPE for primary ovarian, tubal, or peritoneal cancer between October 2012 and November 2016 at our institution. Patient-related, disease-related, and surgery-related data were collected.

Results: One hundred five patients who underwent an MPPE were included in this study. A TDT was placed in all the patients. A diverting ileostomy was created during cytoreductive surgery in 7 patients (7%). Those who underwent a diverting ileostomy tended to have a greater degree of surgical invasiveness, as was reflected by a longer operative time, a serious loss of blood, and a large quantity of intraoperative blood transfusion. Anastomotic leakage occurred in 1 patient (1%), and a diverting ileostomy was created for this patient.

Conclusions: Transanal drainage tube placement seems to be an effective and safe procedure that can decrease the rate of anastomotic leakage and the need for a diverting stoma after MPPE for ovarian cancer. However, some patients inevitably require a diverting stoma despite the TDT placement.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anal Canal / pathology
  • Anal Canal / surgery*
  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / methods
  • Anastomotic Leak / epidemiology
  • Anastomotic Leak / prevention & control
  • Catheterization / adverse effects
  • Catheterization / instrumentation
  • Catheterization / methods
  • Drainage / adverse effects
  • Drainage / instrumentation
  • Drainage / methods*
  • Female
  • Humans
  • Middle Aged
  • Ovarian Neoplasms / epidemiology
  • Ovarian Neoplasms / surgery*
  • Pelvic Exenteration* / adverse effects
  • Pelvic Exenteration* / instrumentation
  • Pelvic Exenteration* / methods
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Treatment Outcome