Surgical Outcomes of Epithelial Ovarian Cancer Patients Who Underwent Intestinal Resection During Primary and Secondary Cytoreductive Surgery

Abstract

Aim: To compare the surgical outcomes of intestinal resections performed during the primary and secondary cytoreductive surgery of epithelial ovarian cancer.Material And Methods: Epithelial ovarian cancer patients who undergone intestinal resection during primary and secondary cytoreductive surgery between January 2009 and December 2017 were retrospectively evaluated with regard to stage, age, surgical operation, type of intestinal resection, anastomosis/ostomy, operation time period, intraoperative transfusion, preoperative albumin level, presence of ascites and level, performance status, intaoperative and postoperative complications.Results: Totally 40 patients who underwent primary n=22 and secondary n=18 cytoreductive surgery were evaluated. Despite no difference in types of intestinal resection between the groups, low anterior resection 5/22, 22.7% and ileal resection 8/18, 44.4% were the most common intestinal resection procedures in primary and secondary cytoreductive surgery group respectively. When radical operations except from intestinal resection were compared between the groups, patients who undergone secondary cytoreductive surgery had statistically significant more radical operations 24 to 14 respectively, p=0.01 . Specifically, tumor excision from lesser sac 3/24 to 0/14, p=0.046 and peritonectomy 6/24 to 1/14, p=0.037 were more commonly performed radical procedures in the secondary cytoreductive surgery group. There was not any difference in the intraoperative and postoperative complication rates.Conclusion: During primary and secondary cytoreductive surgery, to achieve optimal debulking intestinal resection and other radical procedures could be performed without high complication rates.

Keywords

• Ovarian cancer,cytoreduction,bowel,complication,radical

Primer ve Sekonder Sitoredüktif Cerrahi Sırasında İntestinal Rezeksiyon Uygulanan Epitelyal Over Kanseri Olgularında Cerrahi Sonuçların Karşılaştırılması

Abstract

Giriş: Epitelyal over kanseri nedeniyle uygulanan primer ve sekonder sitoredüksiyon sırasında gerçekleştirilen intestinal rezeksiyonların cerrahi sonuçlarını karşılaştırmak.Gereç ve Yöntemler: Ocak 2009 ve Aralık 2017 tarihleri arasında primer ve sekonder sitoredüktif cerrahi esnasında intestinal rezeksiyon yapılmış epitelyal over kanseri hastaları; hastalık evresi, yaş, yapılan cerrahi işlemler, intestinal rezeksiyon tipi, anastomoz/stoma durumu, ameliyat süresi, intraoperatif transfüzyon gereksinimi, preoperatif albumin düzeyi, asit varlığı ve miktarı, performans durumu, intraoperatif ve postoperatif komplikasyonlar yönünden retrospektif olarak karşılaştırıldı.Bulgular: Primer sitoredüksiyon n=22 ve sekonder sitoredüksiyon n=18 uygulanan toplam 40 hasta değerlendirildi. Uygulanan intestinal rezeksiyon prosedürleri açısından her iki grup arasında anlamlı fark olmamakla beraber, primer sitoredüksiyon grubunda en çok low anterior rezeksiyon 5/22, %22,7 , sekonder sitoredüksiyon grubunda ise en çok ileum rezeksiyonunun 8/18, %44,4 uygulandığı saptandı. İntestinal rezeksiyon dışında yapılmış olan radikal cerrahi işlemler karşılaştırıldığında, sekonder sitoredüksiyon grubunda istatistiksel olarak anlamlı derecede daha fazla sayıda cerrahi işlem yapıldığı gözlendi. Radikal prosedürler arasında lesser sac’tan tümör eksizyonu ve peritonektominin sekonder sitoredüksiyon grubunda daha sık yapıldığı belirlendi. İntraoperatif ve postoperatif komplikasyonlar açısından iki grup arasında anlamlı farklılık saptanmadı.Sonuç: Primer ve sekonder sitoredüktif cerrahi sırasında optimal sitoredüksiyon elde etmek amacıyla intestinal rezeksiyonlar ve buna eşlik eden radikal cerrahi prosedürler yüksek komplikasyon oranları oluşturmadan uygulanabilir.

Keywords

• Over kanseri,sitoredüksiyon,barsak,komplikasyon,radikal

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