Left-Sided Subtotal Colectomy for Advanced Serous Carcinoma of the Ovary or Uterus

摘要

Objective: Many radical procedures of tumor resection are reported to accomplish cytoreduction of ovarian cancer. The role of the left-sided subtotal colectomy in the surgical cytoreduction of advanced ovarian or uterine carcinomas is not described in the gynecologic literature. This report describes the methods and outcomes of patients who required subtotal colectomies in an effort to cytoreduce metastatic epithelial ovarian or uterine cancers.Methods: A prospective dataset was kept of all patients with endometrial and ovarian cancers who underwent surgical cytoreduction for advanced disease between May 2002 and September 2004. Patients who underwent left subtotal colectomies as part of the surgical effort were selected and data was retrieved for review.Results: Three patients with advanced serous ovarian or uterine carcinomas underwent left subtotal colectomies as part of surgical cytoreduction. Complete cytoreduction was achieved in two thirds and < 1 cm residual disease remained in one third. The ascending colon and rectum were reanastomosed with a low coloproctostomy in two thirds. An end ascending colostomy was developed in one third. No surgical complications related to the colectomies occurred aside from postoperative ileus. All patients are alive and disease-free with a median follow-up period of 17 months (range, 12-18 months).Conclusions: Left subtotal colectomy is a safe procedure, which allows for maximum surgical cytoreduction and potential survival benefits. Re-anastomosis can be accomplished with good quality-of-life outcomes in selected patients.