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Master Thesis

Morbidité des résections recto-sigmoïdiennes dans la chirurgie de cytoréduction des cancers de l’ovaire

Abstract : Background and aims: Complete cytoreduction is the goal of cytoreductive surgery in advanced epithelial ovarian cancer and rectosigmoid resection is a frequent component of this surgery. The aim of this study was to evaluate the morbidity of rectosigmoid resection at the time of cytoreductive surgery and identify risk factors for complications. Methods: We analysed individual data from all patients undergoing rectosigmoid resection as a part of complete cytoreduction between 2005 and 2013. Previously identified risk factors for complications were analysed, so as the use of bevacizumab in adjuvant or neoadjuvant chemotherapy. Results: 69 patients underwent rectosigmoid resection. 32 had primary cytoreductive surgery, 37 interval cytoreductive surgery. 30.4%, (21/69) patients underwent major complications, and it was higher than without rectosigmoid resection (p=0.006). Anastomotic leak rate was 2.89%. Factors associated with major complications were peritoneal stripping of paracolic gutters (p=0.02) and right diaphragmatic coupola (p=0.005), ascites volume 0.02, initial PCI score 0.009). Independent risk factors were menopausal status ORa=13,7 IC 95% [1,2 ; 161.9], intervalsurgery ORa=4,4 IC 95% [1,1 ; 18.8] and peritoneal stripping of the left paracolic gutter ORa=11.3 IC 95% [2.3 ; 54.3]. Use of bevacizumab was not a risk factor and protective ostomy was not preventive (p=0.71). Conclusions: Morbidity of this surgical procedure is acceptable in order to obtain a complete cytoreduction without residual disease. Protective ileostomy not seems to be a protective factor. Bevacizumab was not associated with higher morbidity
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Master Thesis
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Submitted on : Friday, October 30, 2015 - 11:41:31 AM
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  • HAL Id : dumas-01222615, version 1


Marie Fournier. Morbidité des résections recto-sigmoïdiennes dans la chirurgie de cytoréduction des cancers de l’ovaire. Médecine humaine et pathologie. 2015. ⟨dumas-01222615⟩



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