Son Joo-Hyuk, Kong Tae-Wook, Paek Jiheum, Chang Suk-Joon, Ryu Hee-Sug
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea.
J Surg Oncol. 2019 Jun;119(7):1011-1015. doi: 10.1002/jso.25403. Epub 2019 Feb 8.
To achieve optimal cytoreduction, extensive bowel resections are sometimes required in patients with advanced ovarian cancer. Few studies have focused on the extent or number of resections of bowel surgeries and their feasibility.
We retrospectively reviewed the medical records of patients with advanced ovarian cancer who underwent bowel surgery as part of debulking procedures at Ajou University Hospital from 2006 to 2018. Patients who received extensive bowel resections (two-segment resections or subtotal colectomy) were identified, and their perioperative outcomes were evaluated.
A total of 172 patients underwent bowel surgery. Of them, 128 (74.4%) underwent one-segment bowel resection, 25 (14.5%) underwent two-segment bowel resections, and 19 (11.1%) underwent subtotal colectomy. Although the operative time, transfusion rate, and postoperative bleeding events were higher in patients who underwent extensive bowel resection, the rates of perioperative complications were not significantly higher in this group. Anastomotic leakage occurred in two (1.5%) patients in the one-segment resection group, one (4.2%) patient in the multiple resection group, and two (10.5%) patients in the subtotal colectomy group.
Multiple bowel resections (up to two segments) are feasible and can be safely performed with an acceptable complication rate in patients with advanced ovarian cancer.
为实现最佳的肿瘤细胞减灭，晚期卵巢癌患者有时需要进行广泛的肠切除术。很少有研究关注肠手术切除的范围或数量及其可行性。
我们回顾性分析了2006年至2018年在阿朱大学医院接受肠手术作为肿瘤细胞减灭术一部分的晚期卵巢癌患者的病历。确定接受广泛肠切除术（两段切除术或次全结肠切除术）的患者，并评估其围手术期结局。
共有172例患者接受了肠手术。其中，128例（74.4%）接受了一段肠切除术，25例（14.5%）接受了两段肠切除术，19例（11.1%）接受了次全结肠切除术。虽然接受广泛肠切除术的患者手术时间、输血率和术后出血事件较高，但该组围手术期并发症发生率并无显著升高。一段切除术组有2例（1.5%）患者发生吻合口漏，多段切除术组有1例（4.2%）患者发生吻合口漏，次全结肠切除术组有2例（10.5%）患者发生吻合口漏。
对于晚期卵巢癌患者，多段肠切除术（最多两段）是可行的，并且可以安全地进行，并发症发生率可接受。
