title: Safety and efficacy of low anterior en bloc resection as part of cytoreductive surgery for patients with ovarian cancer.
abstract: OBJECTIVE
  To examine the feasibility and safety of a low anterior resection of the rectosigmoid plus adjacent pelvic tumour as part of primary cytoreduction for ovarian cancer.
  
  
  METHODS
  This study included 65 consecutive patients with primary ovarian cancer who had debulking surgery from 1996 through 2000. All patients underwent an en bloc resection of ovarian cancer and a rectosigmoid resection followed by an end-to-end anastomosis. Parameters for safety and efficacy were considered as primary statistical endpoints for the aim of this analysis.
  
  
  RESULTS
  Postoperative residual tumour was nil, <1 cm, and >1 cm in 14, 34, and 14 patients, respectively. The median postoperative hospital stay was 11 days (range, 6 to 50 days). Intraoperative complications included an injury to the urinary bladder in one patient. Postoperative complications included wound complications (n = 14, 21.5%), septicemia (n = 9, 13.8%), cardiac complications (n = 7, 10.8%), thromboembolic complications (n = 5, 7.7%), ileus (n = 2, 3.1%), anastomotic leak (n = 2, 3.1%), and fistula (n = 1, 1.5%). Reasons for a reoperation during the same admission included repair of an anastomotic leak (n = 1), postoperative hemorrhage (n = 1), and wound debridement (n = 1). Wound complications, septicemia, and anastomotic leak formation were more frequent in patients who had a serum albumin level of < or =30 g/L preoperatively. There was one surgically related mortality in a patient who died from a cerebral vascular accident 2 days postoperatively.
  
  
  CONCLUSIONS
  An en bloc resection as part of primary cytoreductive surgery for ovarian cancer is effective and its morbidity is acceptably low.
authors.affiliation: Queensland Centre for Gynaecological Cancer, Royal Women's Hospital, Brisbane, Australia. a_obermair@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Obermair
authors.forename: S
authors.initials: S
authors.lastname: Hagenauer
authors.forename: D
authors.initials: D
authors.lastname: Tamandl
authors.forename: R D
authors.initials: RD
authors.lastname: Clayton
authors.forename: J L
authors.initials: JL
authors.lastname: Nicklin
authors.forename: L C
authors.initials: LC
authors.lastname: Perrin
authors.forename: B G
authors.initials: BG
authors.lastname: Ward
authors.forename: A J
authors.initials: AJ
authors.lastname: Crandon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D003125:Colostomy / Q000009:adverse effects / Q000379:methods; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery