{"title":"Factors Limiting Ostomy Reversal After Cytoreductive Surgery for Ovarian Cancer: A Retrospective Study.","authors":"Beatriz Navarro Santana, Frederic Guyon, Octavio Arencibia, Guillaume Babin, Eudaldo Tommasetti, Daniel González, Sabrina Piedimonte, Alicia Martín Martínez","doi":"10.21873/anticanres.17270","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aim: </strong>To investigate the factors related to non-reversal of ostomy after cytoreductive surgery in ovarian cancer. In many women with ovarian cancer, transitory ostomies are performed to limit the consequences of anastomotic leak. Although intended to be temporary, a proportion of these ostomies might never be reversed.</p><p><strong>Patients and methods: </strong>This was a retrospective study of patients with 2014 International Federation of Obstetrics and Gynecology stage IIB-IVB ovarian cancer requiring a transitory ostomy during primary or secondary cytoreductive surgery at the Bergonie Institute, France, and the University Hospital of Las Palmas, Spain, between January 2012 and December 2022. Rate of ostomy reversal, its timing (weeks) and postoperative complications were assessed. Multivariate logistic regression analysis was performed to identify limiting factors for ostomy reversal.</p><p><strong>Results: </strong>During the study period, we reviewed data on 181 consecutive patients with ovarian cancer with transitory ostomy creation; 89 (49.2%) patients were not candidates for an ostomy reversal surgery because of disease progression (n=65), death (n=16), and patient's refusal of surgery (n=8). A total of 92 patients were candidates for reversal surgery and were therefore included in the final analysis. In total, 57 (62%) patients had their ostomy reversed. The mean time from ostomy creation to ostomy closure was 47.7 (standard deviation=33.1) weeks. Hartmann's procedure (leaving a rectal stump of 5-6 cm) was identified as an independent predictive factor for non-reversal of ostomy (odds ratio=6.42, 95% confidence interval=1.61-25.53; p=0.008). Complications after ostomy reversal occurred in 32 patients (34.8%).</p><p><strong>Conclusion: </strong>Hartmann's procedure is a limiting factor for ostomy reversal in patients with ovarian cancer. We recommend avoiding Hartmann's procedure during cytoreductive surgery, even after colorectal anastomotic leak.</p>","PeriodicalId":8072,"journal":{"name":"Anticancer research","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anticancer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21873/anticanres.17270","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background/aim: To investigate the factors related to non-reversal of ostomy after cytoreductive surgery in ovarian cancer. In many women with ovarian cancer, transitory ostomies are performed to limit the consequences of anastomotic leak. Although intended to be temporary, a proportion of these ostomies might never be reversed.
Patients and methods: This was a retrospective study of patients with 2014 International Federation of Obstetrics and Gynecology stage IIB-IVB ovarian cancer requiring a transitory ostomy during primary or secondary cytoreductive surgery at the Bergonie Institute, France, and the University Hospital of Las Palmas, Spain, between January 2012 and December 2022. Rate of ostomy reversal, its timing (weeks) and postoperative complications were assessed. Multivariate logistic regression analysis was performed to identify limiting factors for ostomy reversal.
Results: During the study period, we reviewed data on 181 consecutive patients with ovarian cancer with transitory ostomy creation; 89 (49.2%) patients were not candidates for an ostomy reversal surgery because of disease progression (n=65), death (n=16), and patient's refusal of surgery (n=8). A total of 92 patients were candidates for reversal surgery and were therefore included in the final analysis. In total, 57 (62%) patients had their ostomy reversed. The mean time from ostomy creation to ostomy closure was 47.7 (standard deviation=33.1) weeks. Hartmann's procedure (leaving a rectal stump of 5-6 cm) was identified as an independent predictive factor for non-reversal of ostomy (odds ratio=6.42, 95% confidence interval=1.61-25.53; p=0.008). Complications after ostomy reversal occurred in 32 patients (34.8%).
Conclusion: Hartmann's procedure is a limiting factor for ostomy reversal in patients with ovarian cancer. We recommend avoiding Hartmann's procedure during cytoreductive surgery, even after colorectal anastomotic leak.
期刊介绍:
ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed.
ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies).
Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.