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Sites of bowel resected to achieve optimal ovarian cancer cytoreduction: implications regarding surgical management.

Hoffman MS, Griffin D, Tebes S, Cardosi RJ, Martino MA, Fiorica JV, Lockhart JL, Grendys EC

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida, Tampa, USA. macevedo@hsc.usf.edu

OBJECTIVE: The purpose of this study was to 1) report on the distribution of bowel segments resected in a population of patients who underwent primary optimal cytoreductive surgery for epithelial ovarian cancer, and 2) discuss implications for surgical management regarding resection of these bowel segments. STUDY DESIGN: This was a retrospective study from 1995 to 2003 of 144 ovarian cancer patients who underwent primary optimal cytoreductive operations that included bowel resection. RESULTS: Bowel segments removed and major complications are presented in tabulated form. Eighty-one out of 144 resections were rectosigmoid only. Thirty-six percent had extensive involvement of colon segments separate from the rectosigmoid. Excluding hemorrhage, 9 patients (6%) experienced a major complication. CONCLUSION: The present study does suggest the necessity for a highly individualized approach to the surgical management of epithelial ovarian cancer patients who can be optimally cyto-reduced by resection of multifocal colonic involvement. Further study is needed to better assess the complications, function, and oncologic outcome of the different surgical approaches to these patients.

Published 15 August 2005 in Am J Obstet Gynecol, 193(2): 582-6; discussion 586-8.
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