Safety and efficacy of low anterior en bloc resection as part of cytoreductive surgery for patients with ovarian cancer

Objective. To examine the feasibility and safety of a low anterior resectio n of the rectosigmoid plus adjacent pelvic tumour as part of primary cytore duction for ovarian cancer. Methods. This study included 65 consecutive patients with primary ovarian c ancer who had debulking surgery from 1996 through 2000. All patients underw ent an en bloc resection of ovarian cancer and a rectosigmoid resection fol lowed by an end-to-end anastomosis. Parameters for safety and efficacy were considered as primary statistical endpoints for the aim of this analysis. Results. Postoperative residual tumour was nil, <1 cm, and >1 cm in 14, 34, and 14 patients, respectively. The median postoperative hospital stay was 11 days (range, 6 to 50 days). Intraoperative complications included an inj ury to the urinary bladder in one patient. Postoperative complications incl uded wound complications (n=14, 21.5%), septicemia (n=9, 13.8%), cardiac co mplications (n=7, 10.8%), thromboembolic complications (n=5, 7.7%) ileus (n =2, 3.1%) anastomotic leak (n=2, 3.1%) and fistula (n=1, 1.5%). Reasons for a reoperation during the same admission included repair of an anastomotic leak (n=1), postoperative hemorrhage (n=1), and wound debridement (n=1). Wo und complications, septicemia, and anastomotic leak formation were more fre quent in patients who had a serum albumin level of less than or equal to 30 g/L preoperatively. There was one surgically related mortality in a patien t who died from a cerebral vascular accident 2 days postoperatively. Conclusions. An en bloc resection as part of primary cytoreductive surgery for ovarian cancer is effective and its morbidity is acceptably low. (C) 20 01 Academic Press.