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Comparison of posterior rectal dissection techniques during rectosigmoid colon resection as part of cytoreductive surgery in patients with epithelial ovarian cancer: Close rectal dissection versus total mesorectal excision

Authors
Son, JH  | Kim, J | Shim, J | Kong, TW  | Paek, J  | Chang, SJ  | Ryu, HS
Citation
Gynecologic oncology, 153(2). : 362-367, 2019
Journal Title
Gynecologic oncology
ISSN
0090-82581095-6859
Abstract
OBJECTIVE: The aim of this study was to evaluate the clinical outcomes of close rectal dissection (CRD) compared with those of total mesorectal excision (TME) as the posterior rectal dissection procedure during rectosigmoid colectomy performed as part of cytoreductive surgery in patients with epithelial ovarian cancer.
METHODS: We retrospectively reviewed the medical records of 163 patients who underwent posterior rectal dissection for rectosigmoid resection, including low anterior resection or subtotal colectomy, as part of ovarian cancer surgery from 2006 to 2018. The TME technique was mainly performed by colorectal surgeons, and the CRD technique preserving the mesorectal tissue was performed by an experienced gynecologic oncology surgeon. The patients were divided into the TME group and the CRD group, and their clinical outcomes were analyzed.
RESULTS: A total of 163 patients with ovarian cancer underwent rectosigmoid colon resection. Among the patients, 87 (53.4%) underwent CRD and 76 (46.6%) underwent TME as the posterior rectal dissection technique. The disease severity according to FIGO stage (p=.390) and the residual disease status (p=.412) were not statistically different between the 2 groups. However, the postoperative incidences of anastomotic leakage (p=.045) and prolonged ileus (>7days, p=.055) were higher in the TME group. The pelvic recurrence rate and progression-free survival did not differ between the 2 groups (p=.663 and .790, respectively).
CONCLUSIONS: Considering the perioperative outcomes, CRD may be an alternative technique for rectal dissection in ovarian cancer with less perioperative morbidity and equivalent oncologic outcomes.
Keywords
MeSH

DOI
10.1016/j.ygyno.2019.02.029
PMID
30846223
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Obstetrics & Gynecology
Ajou Authors
공, 태욱  |  백, 지흠  |  손, 주혁  |  유, 희석  |  장, 석준
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