Risk factors for anastomotic leakage after colorectal resection in ovarian cancer surgery: A multi-centre study.
Gynecol Oncol
; 153(3): 549-554, 2019 06.
Article
em En
| MEDLINE
| ID: mdl-30952369
ABSTRACT
OBJECTIVE:
To determine pre-/intraoperative risk factors for anastomotic leak after modified posterior pelvic exenteration (MPE) or colorectal resection in ovarian cancer and to create a practical instrument for predicting anastomotic leak risk.BACKGROUND:
In advanced ovarian cancer surgery, there is rather limited published evidence, drawn from a small sample, providing information about risk factors for anastomotic leak.METHODS:
Eight hospitals participated in this retrospective study. Data on 695 patients operated for ovarian cancer with primary anastomosis were included (January 2010-June 2018). Twelve pre-/intraoperative variables were analysed as potential independent risk factors for anastomotic leak. A predictive model was created to stablish the risk of anastomotic leak for a given patient.RESULTS:
The anastomotic leak rate was 6.6% (46/695; range 1.7%-12.5%). A total of 457 patients were included in the final multivariate analysis. The following variables were found to be independently associated with anastomotic leakage age at surgery (OR 1.046, 95% CI 1.013-1.080, pâ¯=â¯0.005), serum albumin level (OR 0.621, 95% CI 0.407-0.948, pâ¯=â¯0.027), one or more additional small bowel resections (OR 3.544, 95% CI 1.228-10.23, pâ¯=â¯0.019), manual anastomosis (OR 8.356, 95% CI 1.777-39.301, pâ¯=â¯0.007) and distance of the anastomosis from the anal verge (OR 0.839, 95% CI 0.726-0.971, pâ¯=â¯0.018).CONCLUSIONS:
Due to the low incidence of AL in ovarian cancer patients, a restrictive stoma policy based on the presence of risk factors should be the actual recommendation. Hand-sewn anastomosis should be avoided.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Ovarianas
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Exenteração Pélvica
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Colectomia
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Fístula Anastomótica
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Protectomia
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Recidiva Local de Neoplasia
Tipo de estudo:
Etiology_studies
/
Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Gynecol Oncol
Ano de publicação:
2019
Tipo de documento:
Article