He Xinlin, Li Zhengyu
Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.
Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
Front Oncol. 2022 May 23;12:892376. doi: 10.3389/fonc.2022.892376. eCollection 2022.
Debulking cytoreduction surgery with bowel resection is a common intervention for ovarian cancer. It is controversial whether ostomy causes worse survival outcomes and how clinical physicians should choose which patients to undergo ostomy. During this study, we performed a systematic review to determine whether ostomy leads to worse outcomes after bowel resection compared to anastomosis. We also summarized the possible indications for ostomy.
We searched PubMed, Embase, and Cochrane for articles containing the phrase "ovarian cancer with bowel resection" that were published between 2016 and 2021. We included studies that compared primary anastomosis with ostomy. We mainly focused on differences in the anastomotic leakage rate, length of hospital stay, overall survival, and other survival outcomes associated with the two procedures.
Of the 763 studies, three were ultimately included in the systematic review (N=1411). We found that ostomy did not contribute to worse survival outcomes, and that the stoma-related complications were acceptable. Indications for ostomy require further study. Bowel resection segment margins and the distance from the anastomosis to the anal verge require consideration.
肠道切除减瘤细胞减灭术是卵巢癌的常见干预措施。造口术是否会导致更差的生存结果以及临床医生应如何选择接受造口术的患者存在争议。在本研究中，我们进行了一项系统评价，以确定与吻合术相比，造口术在肠道切除术后是否会导致更差的结果。我们还总结了造口术的可能适应证。
我们在PubMed、Embase和Cochrane中检索了2016年至2021年发表的包含“卵巢癌伴肠道切除”短语的文章。我们纳入了比较一期吻合术和造口术的研究。我们主要关注两种手术在吻合口漏率、住院时间、总生存期及其他生存结局方面的差异。
在763项研究中，最终有3项被纳入系统评价（N = 1411）。我们发现造口术不会导致更差的生存结果，且造口相关并发症是可接受的。造口术的适应证需要进一步研究。需要考虑肠道切除段切缘以及吻合口到肛缘的距离。
