Department of Gynaecologic Oncology, Nuffield Department of Women and Reproductive Health, University of Oxford, Oxford, United Kingdom.
J Gynecol Oncol. 2019 Mar;30(2):e25. doi: 10.3802/jgo.2019.30.e25. Epub 2018 Nov 30.
To assess the morbidity associate with rectosigmoid resection (RSR) in patients with stage IIIC-IV ovarian cancer (OC) undergone primary debulking surgery (PDS) vs. interval debulking surgery (IDS) after neoadjuvant chemotherapy (NACT).
From the Oxford Advanced OC database, we retrieved all patients who underwent surgery between January 2009 and July 2016 and included all patients who underwent RSR. We compared the rates of overall related and not-related morbidity and bowel diversion in patients undergone RSR during PDS vs. IDS.
Three hundred and seventy-one patients underwent surgery: 126 in PDS group and 245 in IDS group. Fifty-two patients in the PDS group (41.3%) and 65 patients in IDS group (26.5%) underwent RSR (p<0.001). Overall not related morbidity rate was 37.5% and 28.6%, p=0.625. Bowel specific complications affected 16.3% vs. 11.1% of the patients (p=0.577). IDS group had higher rate of bowel diversion compared with PDS (46.0% vs. 26.5%, p=0.048).
NACT was associated to an overall reduced rate of RSR compared to IDS. No differences in overall related and not-related complications in patients requiring RSR were seen between the 2 groups. Patients in the IDS group had a significantly higher rate of bowel diversion.
评估接受新辅助化疗（NACT）后行初次肿瘤细胞减灭术（PDS）与间隔肿瘤细胞减灭术（IDS）的 IIIC-IV 期卵巢癌（OC）患者行直肠乙状结肠切除术（RSR）的发病率。
我们从牛津高级 OC 数据库中检索了 2009 年 1 月至 2016 年 7 月间接受手术的所有患者，并纳入所有接受 RSR 的患者。我们比较了在 PDS 与 IDS 下行 RSR 的患者的总相关和非相关发病率以及肠道转流率。
371 例患者接受了手术：PDS 组 126 例，IDS 组 245 例。PDS 组中有 52 例（41.3%）和 IDS 组中有 65 例（26.5%）患者行 RSR（p<0.001）。总非相关发病率为 37.5%和 28.6%，p=0.625。肠道特异性并发症分别影响 16.3%和 11.1%的患者（p=0.577）。与 PDS 相比，IDS 组肠道转流率更高（46.0% vs. 26.5%，p=0.048）。
与 IDS 相比，NACT 与 RSR 总体发生率降低相关。在需要 RSR 的患者中，两组之间总相关和非相关并发症无差异。IDS 组患者肠道转流率明显更高。
