Sigmoid Colectomy As Citoreductive Surgery In Advanced Ovarian Carcinoma
Keywords:
ovarian neoplasms, surgical treatment, bowel resection, indication, morbidityAbstract
Objective
To carry out a retrospective study describing four cases of ovarian carcinoma, whose surgical treatment involved sigmoidectomy.
Methods
The medical records of 60 patients with ovarian carcinoma were checked, treated at the Center for Comprehensive Attention to Women's Health from January 1997 to January 2002. Among them, 38 had advanced disease - stages Ili and IV of the International Federation of Gynecology and Obstetrics, and 4 (10.4%) underwent sigmoid resection. The average age of the four patients analyzed was 60.5 years and none of them had a history of other previous or associated gynecological neoplasia. The patients had varying degrees of involvement of the digestive system, and three underwent rectosigmoidectomy and one, partial sigmoidectomy. The primary anastomosis was performed in two patients and, in the other two, a terminal colostomy was performed.
Results
Cytoreduction was considered excellent in three patients and fever was the most frequent postoperative complication. The four women evaluated received subsequent chemotherapy treatment with carboplatin and cyclophosphamide. In a follow-up period of 18 to 60 months, two women presented recurrence with an increase in CA 125 and one died due to pulmonary metastasis.
Conclusion
Despite the small number of patients undergoing sigmoid resection for cytoreduction due to advanced ovarian carcinoma, it is important to carry out adequate pre-operative preparation, guide the patient regarding the surgical scope, risks and possible complications and have a surgical team qualified to perform gynecological surgeries associated with interventions in the gastrointestinal tract.
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