Transverse colectomy in ovarian cancer surgical cytoreduction: Operative technique and clinical outcome

Robert E. Bristow, Michele Peiretti, Vanna Zanagnolo, Ritu Salani, Robert L. Giuntoli, Angelo Maggioni

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To describe the operative techniques and associated clinical outcomes of patients undergoing transverse colectomy as a component of cytoreductive surgery for advanced or recurrent ovarian cancer. Methods: Thirty-nine patients underwent transverse colectomy as part of primary (n = 33) or secondary (n = 6) cytoreductive surgery for ovarian cancer between 1/97 and 4/07. The surgical techniques, associated morbidity, and clinical outcomes are described. Results: Among primary surgery patients, 75.6% had Stage IIIC disease, and 24.2% had Stage IV disease. Transverse colon surgery consisted of: partial colectomy in 33 cases and total transverse colectomy in 6 cases. Transverse colectomy with rectosigmoid colectomy was performed in 61.5% of patients, with two separate colonic anastomoses in 48.7%. The majority (89.7%) of transverse colon anastomoses were stapled, most commonly a functional end-to-end colocolostomy. Two patients required end colostomy. The median EBL was 500 cm3. Residual disease was: no gross in 33.3%, 0.1-1.0 cm in 59.0%, and > 1 cm in 7.7% of patients. Post-operative morbidity occurred in 25.6% of patients, with a fistula rate of 5.1% and a mortality rate of 2.6%. The median survival time after primary surgery was 68.3 months. Conclusions: Transverse colectomy can contribute significantly to a maximal ovarian cancer cytoreductive surgical effort and carries acceptable morbidity. Resection of a non-contiguous segment of rectosigmoid colon is frequently necessary, and placement of two separate colonic anastomoses is associated with a low risk of anastomotic breakdown.

Original languageEnglish (US)
Pages (from-to)364-369
Number of pages6
JournalGynecologic oncology
Volume109
Issue number3
DOIs
StatePublished - Jun 1 2008

Keywords

  • Bowel resection
  • Cytoreduction
  • Ovarian cancer

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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