Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
BMC Surg. 2022 Mar 4;22(1):81. doi: 10.1186/s12893-022-01531-0.
To review the utilization of bowel resection in ovarian cancer surgery in our institution.
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).
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.
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%.
回顾本机构卵巢癌手术中肠切除术的应用情况。
确定 2006/01 年至 2018/12 年间接受肠切除术的所有卵巢癌患者。根据 Clavien-Dindo 分类（CDC）评估术后并发症。
吻合组 182 例，造口组 100 例，共 282 例。中位年龄为 57 岁，大多数患者为高级别浆液性组织学（88.7%）。49 例（17.3%）患者接受新辅助化疗。术中 78.7%的患者有腹水，中位量为 800ml。广泛肠切除（至少两段）和上腹部手术分别在 29 例（10.2%）和 69 例（24.4%）患者中进行。直肠乙状结肠是最常切除的部位（83.8%），其次是右半结肠切除术（5.9%）和小肠切除术（2.8%）。42.9%的患者无肉眼残留病灶，87.9%的患者残留病灶≤1cm。在整个队列中，23.0%（65/282）出现不同的并发症。严重并发症（CDC 3-5）占并发症的 9.2%，主要为需要引流的胸腔积液（3.5%），其次为需要在手术室延迟修复的伤口裂开（1.8%）。9 例患者发生吻合口漏（AL）：1 例在造口组，广泛肠切除，8 例在吻合组。吻合口总的 AL 发生率为 4.2%（9/212）。
在新诊断为卵巢癌的患者中，作为减瘤手术的一部分进行肠切除术导致严重发病率为 9.2%。
