RT Journal Article
SR Electronic
T1 Prevention of Anastomotic Leakage in Ovarian Cancer Debulking Surgery and Its Impact on Overall Survival
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 5209
OP 5218
DO 10.21873/anticanres.13718
VO 39
IS 9
A1 ARNE KOSCIELNY
A1 ANNA KO
A1 EVA K. EGGER
A1 WALTER KUHN
A1 JÖRG C. KALFF
A1 MIGNON-DENISE KEYVER-PAIK
YR 2019
UL http://ar.iiarjournals.org/content/39/9/5209.abstract
AB Aim: The aim of this retrospective study was to investigate the impact of anastomotic leakage on survival rate and to define potential factors of risk and protection from bowel anastomotic leakage in patients with bowel segment resection treated for epithelial ovarian cancer in an accredited high-volume center. Patients and Methods: Data of 136 patients treated with bowel resection between 2010 and 2017 were collected. All operations were performed by three accredited gynecological oncologists and by two specialized colorectal surgeons. Survival and anastomotic leakage rates were analyzed as per preoperative treatment, number and localization of anastomoses, grading of ovarian cancer, and protective loop ileostomy. Results: In total, anastomotic leakage was observed in 23 out of 165 anastomoses (13.9%), representing 23 anastomotic leakages in 136 patients (16.9%). The 30-day mortality rate was 0.73%. There was no statistically significant difference in anastomotic leakage rate depending on localization and number of anastomoses (p=0.634). Patients with a protective loop ileostomy (n=22/136 patients) had no anastomotic leakage (0.0%, p=0.021). The anastomotic leakage rate was significantly different in patients without protective loop ileostomy depending on bevacizumab administration [no bevacizumab: 15/111 (13.5%) vs. bevacizumab administration: 4/8 (50.0%), p=0.007]. Tumor-positive resection margins in bowel segments were an independent prognostic factor (relative risk=6.3; 95% confidence intervaI=3.1-12.9). Conclusion: In this data set, protective loop ileostomy likely reduced the anastomotic leakage rate after bowel resection in selected cases of ovarian cancer treated with debulking surgery. Especially in patients treated with bevacizumab, protective loop ileostomy should be considered. There was no significant impact of leakage rate on overall survival.