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Outcomes of colorectal anastomoses during pelvic exenteration for gynaecological malignancy

Cited 7 time in Web of Science Cited 8 time in Scopus
Authors
Lim, S.-W.; Lim, S.-B.; Park, J.-Y.; Park, S.-Y.; Choi, H. S.; Jeong, S.-Y.
Issue Date
2008-04-18
Publisher
Wiley-Blackwell
Citation
Br J Surg. 2008 ;95(6):770-3.
Keywords
AdolescentAgedAnastomosis, SurgicalBlood Loss, SurgicalChildColon/*surgeryFemaleGenital Neoplasms, Female/*surgeryHumansLength of StayMiddle AgedPelvic Exenteration/*methodsRectum/*surgeryRisk FactorsSurgical Wound Dehiscence/etiologyTreatment Outcome
Abstract
BACKGROUND: Although pelvic exenteration is frequently indicated during surgery for gynaecological malignancy, performing a colorectal anastomosis remains contentious because of concern about leakage. This study evaluated the safety of performing a low colorectal anastomosis during pelvic exenteration for gynaecological malignancy. METHODS: Between April 2001 and December 2006, 145 consecutive patients underwent low colorectal anastomosis without (122) or with (23) a stoma after pelvic exenteration for advanced primary or recurrent gynaecological malignancy. Subjects were assessed in terms of five patient-, four disease- and two surgery-related variables. The proportion of patients with each risk factor for leakage was found, and the rate of symptomatic anastomotic leakage was determined. RESULTS: The mean age of the patients was 53.5 (range 10-77) years and the most common diagnosis was ovarian cancer (77.9 per cent). The mean operating time was 453 (range 145-845) min and the mean blood loss was 1080 (range 110-10 500) ml; 95 patients (65.5 per cent) required a blood transfusion. Of the 145 patients, 81 (55.9 per cent) had patient-related, 94 (64.8 per cent) had disease-related and 67 (46.2 per cent) had surgery-related variables associated with a risk of leakage. Symptomatic anastomotic leakage developed in three patients (2.1 per cent). CONCLUSION: Although patients with gynaecological malignancy carry considerable risks associated with anastomotic leakage, carefully executed low colorectal anastomosis during pelvic exenteration was found to be safe.
ISSN
1365-2168 (Electronic)
0007-1323 (Print)
Language
English
URI
https://hdl.handle.net/10371/62843
DOI
https://doi.org/10.1002/bjs.6135
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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