A restrictive stoma policy after colorectal anastomosis in ovarian cancer based on ghost ileostomy use.

Autor: Lago V; Gynecologic Oncology Unit, University Hospital La Fe, Valencia, Spain; CEU Cardenal Herrera University, Valencia, Spain. Electronic address: victor.lago.leal@hotmail.com., Albert MM; Gynecologic Oncology Unit, University Hospital La Fe, Valencia, Spain., Cruz MA; Gynecologic Oncology Unit, University Hospital La Fe, Valencia, Spain., Guijarro Campillo RA; University Hospital La Arrixaca, Murcia, Spain., Padilla-Iserte P; Gynecologic Oncology Unit, University Hospital La Fe, Valencia, Spain., Matute L; Gynecologic Oncology Unit, University Hospital La Fe, Valencia, Spain., Gurrea M; Gynecologic Oncology Unit, University Hospital La Fe, Valencia, Spain., Flor B; Colorectal Surgery Unit, University Hospital La Fe, Valencia, Spain., Domingo S; Gynecologic Oncology Unit, University Hospital La Fe, Valencia, Spain.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2024 Jun; Vol. 50 (6), pp. 108325. Date of Electronic Publication: 2024 Apr 11.
DOI: 10.1016/j.ejso.2024.108325
Abstrakt: Background: The incidence of anastomotic leak after colorectal anastomosis in ovarian cancer has been reported to be much lower than that in colorectal cancer patients. Regarding the use of protective manoeuvres (diverting ileostomy) as suggested by clinical guidelines, the goal should be the implementation of a restrictive stoma policy for ovarian cancer patients, given the low rate of anastomotic leakage in this population.
Material and Methods: Patients who underwent cytoreduction surgery in a single centre (University Hospital La Fe, Valencia Spain) due to ovarian cancer between January 2010 and June 2023 were classified according to two groups: a non-restrictive stoma policy group (Group A) and a restrictive stoma policy group (Group B).
Results: A total of 256 patients were included in the analysis (group A 52 % vs group B 48 %). The use of protective diverting ileostomy was lower in the restrictive stoma policy group (14 % vs 6.6 %), and the use of ghost ileostomy was 32 % vs 87 % in groups A and B, respectively (p < 0.00001). No differences were found in the anastomotic leak rate, which was 5.2 % in the non-restrictive group and 3.2 % in the restrictive stoma policy group (p = 0.54).
Conclusion: The use of a restrictive stoma policy based on the use of ghost ileostomy reduces the rate of diverting ileostomy in patients with ovarian cancer after colorectal resection and anastomosis. Furthermore, this policy is not associated with an increased rate of anastomotic leakage nor with an increased rate of morbi-mortality related to the leak.
Competing Interests: Declaration of competing interest We declare not to have any conflict of interest.
(© 2024 Elsevier Ltd, BASO ∼ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
Databáze: MEDLINE
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