Department of Gynaecologic Oncology, Division of Women's and Children, Churchill Hospital, Oxford, UK.
Department of Gynaecologic Oncology, Division of Women's and Children, Churchill Hospital, Oxford, UK; Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
Eur J Obstet Gynecol Reprod Biol. 2019 Sep;240:215-219. doi: 10.1016/j.ejogrb.2019.07.011. Epub 2019 Jul 13.
To assess the impact of multiple bowel resections on postoperative outcomes in stage IIIC-IV ovarian cancer (OC).
From the Oxford OC database we retrieved consecutive patients who underwent bowel resection between January 2009 and November 2017. Patients were divided into two groups: single bowel resection (SBR) and MBR (≥2 bowel resections). The following outcomes were compared between the two groups: 30-day related and not related morbidity to bowel surgery, bowel diversion rate and time to start/restart adjuvant chemotherapy.
Thirty-five patients were in the MBR and 146 in the SBR group. The 30-day overall surgical-related complication and bowel specific complications rate was higher in MBR group than SBR group (54.3% vs. 23.9%, p < 0.001) and (25.7% vs. 10.5%, p = 0.035), respectively. The rate of bowel diversion was 97.7% in MBR vs. 26.7% in the SBR group (p = 0.021). Trend analysis showed a significant reduction in the rate of MBR after the introduction of NACT (p- for trend <0.001).
Our data show that MBR during OC surgery is associated with a higher rate of overall and bowel specific complication compared to SBR. The introduction of NACT is associated with a reduced rate of MBR.
评估 IIIC-IV 期卵巢癌（OC）患者多次肠切除术对术后结局的影响。
我们从牛津 OC 数据库中检索了 2009 年 1 月至 2017 年 11 月期间接受肠切除术的连续患者。患者分为两组：单肠切除术（SBR）和多肠切除术（MBR，≥2 次肠切除术）。比较两组之间的以下结果：30 天相关和不相关的肠手术发病率、肠转流率和开始/重新开始辅助化疗的时间。
35 例患者在 MBR 组，146 例患者在 SBR 组。MBR 组的 30 天总手术相关并发症和肠特异性并发症发生率高于 SBR 组（54.3%比 23.9%，p<0.001）和（25.7%比 10.5%，p=0.035）。MBR 组的肠转流率为 97.7%，SBR 组为 26.7%（p=0.021）。趋势分析显示，在引入新辅助化疗后，MBR 的发生率显著降低（p<0.001）。
我们的数据表明，与 SBR 相比，OC 手术中的 MBR 与更高的总体和肠特异性并发症发生率相关。引入新辅助化疗与 MBR 发生率降低相关。
