COLORECTAL ANASTOMOSIS ON A GYNECOLOGIC ONCOLOGY SERVICE

This is an evaluation of our experience with colorectal reanastomosis on a gynecologic oncology service. A retrospective review was carried out on all patients who underwent colorectal resection and reanastomos is on the gynecologic oncology service from October 1, 1987 to Septemb er 30, 1992. Thirty-nine procedures were performed: Nine patients unde rwent sigmoidectomy alone, 20 also underwent cytoreduction, and 10 als o underwent exenteration. Thirty-eight percent of the patients had und ergone prior radiotherapy. The level of anastomosis above the anal ver ge was 3-5 cm in 9 patients, 6-9 cm in 20 patients, and 10-14 cm in 10 patients. Sixteen had a protective colostomy which included 13 of the 15 patients with prior radiotherapy. Thirteen of the protective colos tomies were taken down, although three of these required a second perm anent colostomy. Three other patients required colostomy at a later da te, one of whom developed a rectovaginal fistula 10 days following exe nteration for postradiation recurrent carcinoma of the cervix. A total of 30 of the 37 evaluable patients (81%) had an ultimately functional colorectal reanastomosis. Problems related to colorectal function inc luded stricture (4), fistula (4), chronic diarrhea (3), tenesmus (1), and fecal incontinence (1). Colorectal anastomosis is a worthwhile end eavor in selected patients with gynecologic cancer. (C) 1994 Academic Press, Inc.