abstract
2016 May 31
OBJECTIVE:
To
examine the use, as well as postoperative and long-term oncologic
outcomes of diverting loop ileostomy (DI) during primary debulking
surgery (PDS) for ovarian cancer.
METHODS:
Patients
with stage II-IV ovarian, fallopian tube, or primary peritoneal
carcinoma who underwent colon resection during PDS from 1/2005-1/2014
were identified. Demographic and clinical data were analyzed.
RESULTS:
Of
331 patients, 320 (97%) had stage III/IV disease and 278 (84%) had
disease of high-grade serous histology. Forty-four (13%) underwent a DI.
There were no significant differences in age, comorbidity index,
smoking status, serum albumin, or attending surgeon between the DI and
non-DI groups. Operative time and
length of rectosigmoid resection were predictors of DI on multivariable analysis. The overall anastomotic
leak rate was 6%. A comparison of groups (DI vs non-DI) showed no
significant differences in major complications (30% vs 23%; p=0.41),
anastomotic leak rate (5% vs 7%; p=0.60), hospital length of stay (10 vs
9days; p=0.25), readmission rate (23% vs 17%; p=0.33), or interval to
postoperative chemotherapy (41 vs 40days; p=0.20), respectively.
Ileostomy reversal was successful in 89% of patients. Median follow-up
was 52.6months. There were no differences in median progression-free
(17.9 vs 18.6months; p=0.88) and overall survival (48.7 vs 63.8months;
p=0.25) between the groups.
CONCLUSIONS:
In
patients undergoing PDS, those with longer operative time and greater
length of rectosigmoid resection more commonly underwent DI. DI does not
appear to compromise postoperative outcomes or long-term survival.
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