Women who underwent bowel resection or repair during cytoreductive surgery for ovarian cancer had significantly higher odds of developing a surgical infection compared with women who underwent surgery without bowel resection or repair, a retrospective cohort analysis found. The study findings were recently reported in Gynecologic Oncology.
The analysis included 4965 women who underwent cytoreductive surgery for an advanced ovarian malignancy between 2006 and 2017. Women in the analysis were retrospectively identified from the American College of Surgeons National Surgical Quality Improvement Program and divided into 2 groups: women who had a bowel procedure and women who did not.
More than three-quarters of women did not undergo bowel resection or repair at the time of cytoreductive surgery. Among the remaining 21.3% of women who did, 8.3% had an associated repair of enterotomy, 10.9% had an associated colectomy with primary anastomosis, and 2.1% had an associated colectomy with colostomy.
Surgical site infection — which included superficial incisional, deep incisional, organ space, or wound dehiscence — occurred more frequently among women who had a bowel procedure compared with women who did not (16.9% vs 5.7%, respectively; P <.001).
An adjusted analysis revealed that the odds of developing a surgical infection after surgery more than doubled in women who had bowel resection or repair (odds ratio, 2.67; 95% CI, 1.7–4.14; P =.0001).
The higher frequency of surgical site infection among women who had a bowel procedure did not translate to a higher mortality rate. Overall, 0.2% of women who had a bowel procedure and 0.5% of women who did not have a bowel procedure died — mortality rates that the study authors described as “extremely” low.
“Bowel resection or repair at the time of cytoreductive surgery for ovarian cancer is associated with significant morbidity, despite adjusting for factors that might predispose these patients to postoperative complications,” the study authors concluded.
Bernard L, Boucher J, Helpman L. Bowel resection or repair at the time of cytoreductive surgery for ovarian malignancy is associated with increased complication rate: An ACS-NSQIP study [published online July 6, 2020]. Gynecol Oncol. doi: 10.1016/j.ygyno.2020.06.504