Anastomosis Is Possible with an Acceptable Low Rate of Complications Compared to a Diverting Stoma in Surgery for Ovarian Cancer

摘要

Radical surgery for advanced stage of ovarian cancer may lead to bowel resection and consequently either an anastomosis or a diverting stoma. This study investigates whether it is possible to find selection criteria which predict benefits from an anastomosis compared to a diverting stoma, in order to prevent complications and leakage. Consecutive patients with ovarian/tuba/peritoneal cancer undergoing initial bowel resection at Aarhus University Hospital, Denmark, between March 2012 and December 2015 were retrospectively identified. Among 67 patients with bowel resections, 32 patients had a stoma and 35 patients had an anastomosis. No significant differences were observed in the two groups regarding age, BMI, smoking, ASA classification, FIGO stage, plasma albumin, the ability to undergo radical surgery, or time to initiate chemotherapy. The length of hospital stay was longer for patients with a stoma (P=0.01). An anastomotic leakage lead to reoperation for 8.6% of the anastomosis patients. Patients who were reoperated due to leakage, initiated chemotherapy after 21-45 days. Only smoking was identified as a preoperative risk factor for leakage after bowel anastomosis in relation to debulking surgery for ovarian cancer. The complication rate among patients with an anastomosis was acceptably low, and the time from surgery to start of chemotherapy was the same as in patients with a stoma. This study supports the hypothesis that an anastomosis can be safely performed in patients with advanced ovarian cancer.