The surgical outcomes and perioperative complications of bowel resection as part of debulking surgery of advanced ovarian cancer patients

BMC Surg. 2022 Mar 4;22(1):81. doi: 10.1186/s12893-022-01531-0.

Abstract

Background: To review the utilization of bowel resection in ovarian cancer surgery in our institution.

Methods: All ovarian cancer patients who received bowel resection between 2006/01 and 2018/12 were identified. Postoperative morbidities were assessed according to the Clavien-Dindo classification (CDC).

Results: There were 182 patients in the anastomosis group and 100 patients in the ostomy group, yielding a total of 282 patients. The median age was 57 years, and most patients had high-grade serous histology (88.7%). Forty-nine (17.3%) patients received neoadjuvant chemotherapy. During the operation, 78.7% of patients had ascites, and the median volume was 800 mL. Extensive bowel resection (at least two-segment) and upper abdominal operation were performed in 29 (10.2%) and 69 (24.4%) patients, respectively. The rectosigmoid colon was the most commonly resected (83.8%) followed by right hemicolectomy (5.9%) and small bowel resection (2.8%). No macroscopic residual disease was observed in 42.9% of the patients, whereas 87.9% had residual disease ≤ 1 cm. Among the entire cohort, 23.0% (65/282) experienced different complications. Severe complications (CDC 3-5) accounted for 9.2% of complications and were mostly categorized as pleural effusion requiring drainage (3.5%) followed by wound dehiscence requiring delayed repair in the operating room (1.8%). Nine patients experienced anastomotic leakage (AL): one in the ostomy group with extensive bowel resection and eight in the anastomosis group. The overall AL rate was 4.2% (9/212) per anastomosis.

Conclusions: The execution of bowel resection as part of debulking surgery in patients with newly diagnosed ovarian cancer resulted in a severe morbidity rate of 9.2%.

Keywords: Bowel resection; Complications; Ovarian carcinoma; Surgical outcomes.

MeSH terms

  • Colectomy / methods
  • Colon, Sigmoid / pathology
  • Cytoreduction Surgical Procedures* / methods
  • Humans
  • Middle Aged
  • Ovarian Neoplasms* / surgery
  • Retrospective Studies
  • Treatment Outcome