Kato Kazuyoshi, Omatsu Kohei, Okamoto Sanshiro, Matoda Maki, Nomura Hidetaka, Tanigawa Terumi, Aoki Yoichi, Yunokawa Mayu, Kanao Hiroyuki
Department of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan.
Present address: Department of Obstetrics and Gynecology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
World J Surg Oncol. 2021 Mar 15;19(1):77. doi: 10.1186/s12957-021-02186-6.
The aim of this study was to investigate the safety and clinical usefulness of early oral feeding (EOF) after rectosigmoid resection with anastomosis for the treatment of primary ovarian cancer.
We performed a retrospective review of all consecutive patients who had undergone rectosigmoid resection with anastomosis for primary ovarian, tubal, or peritoneal cancer between April 2012 and March 2019 in a single institution. Patient-related, disease-related, and surgery-related data including the incidence of anastomotic leakage and postoperative hospital stay were collected. EOF was introduced as a postoperative oral feeding protocol in September 2016. Before the introduction of EOF, conventional oral feeding (COF) had been used.
Two hundred and one patients who underwent rectosigmoid resection with anastomosis, comprised of 95 patients in the COF group and 106 patients in the EOF group, were included in this study. The median number of postoperative days until the start of diet intake was 5 (range 2-8) in the COF group and 2 (range 2-8) in the EOF group (P < 0.001). Postoperative morbidity was equivalent between the groups. The incidence of anastomotic leakage was similar (1%) in both groups. The median length of the postoperative hospital stay was reduced by 6 days for the EOF group: 17 (range 9-67) days for the COF group versus 11 (8-49) days for the EOF group (P < 0.001).
EOF provides a significant reduction in the length of the postoperative hospital stay without an increased complication risk after rectosigmoid resection with anastomosis as a part of cytoreductive surgery for primary ovarian cancer.
本研究旨在探讨乙状结肠直肠切除吻合术后早期经口进食（EOF）在原发性卵巢癌治疗中的安全性及临床实用性。
我们对2012年4月至2019年3月期间在单一机构接受乙状结肠直肠切除吻合术治疗原发性卵巢癌、输卵管癌或腹膜癌的所有连续患者进行了回顾性研究。收集了患者相关、疾病相关及手术相关数据，包括吻合口漏发生率及术后住院时间。2016年9月引入EOF作为术后经口进食方案。在引入EOF之前，采用的是传统经口进食（COF）。
本研究纳入了201例行乙状结肠直肠切除吻合术的患者，其中COF组95例，EOF组106例。COF组术后开始进食的中位天数为5天（范围2 - 8天），EOF组为2天（范围2 - 8天）（P < 0.001）。两组术后发病率相当。两组吻合口漏发生率相似（均为1%）。EOF组术后住院时间中位数缩短了6天：COF组为17天（范围9 - 67天），EOF组为11天（8 - 49天）（P < 0.001）。
作为原发性卵巢癌肿瘤细胞减灭术一部分的乙状结肠直肠切除吻合术后，EOF可显著缩短术后住院时间，且不增加并发症风险。
