Safety and Efficacy of Low Anterior en Bloc Resection as Part of Cytoreductive Surgery for Patients with Ovarian Cancer

Malnutrition among gynaecological cancer patients

“…This indicates that albumin rather than weight loss would be a better indicator of malnutrition in gynaecological cancer patients, should a full nutritional assessment not be feasible. Obermair et al (2001) indicated that surgically related complications such as wound defects and septicaemia were more frequent in ovarian cancer patients who had a serum albumin level of p30 g/l preoperatively compared to patients with higher albumin levels.…”

“…In patients requiring surgery, the clinical impact of malnutrition includes an increased risk of peri-operative complications (Terada et al, 1988;Burnett et al, 1993;Obermair et al, 2001), increased postoperative residual tumour after initial surgery (Obermair et al, 2001) and increased length of hospital stay (Massad et al, 1993). A significant proportion of patients with gynaecological malignancies seem to experience malnutrition (Orr et al, 1985a, b;Spirtos and Ballon, 1988;Santoso et al, 2000;Gadducci et al, 2001) and patients with advanced ovarian cancer are particularly at risk (Tunca, 1983;Dickerson et al, 1995).…”

“…Various nutritional parameters such as Prognostic Nutritional Indices (Santoso et al, 2000), serum albumin, total protein, transferrin (Spirtos and Ballon, 1988;Obermair et al, 2001), haemoglobin (Massad et al, 1993) and anthropometric measurements including weight (Spirtos and Ballon, 1988;Donato et al, 1992;Santoso et al, 2000) have been used to assess the nutritional status in gynaecological cancer patients. The subjective global assessment (SGA) is a validated nutrition assessment tool that is commonly used to assess nutritional status of patients with a number of different conditions (Baker et al, 1982;Detsky et al, 1987;Hirsch et al, 1991).…”

Ovarian Cancer Surgery – A Population-based Registry Study

“…The most common additional debulking procedure is colon resection, as this is, in many cases, required for the optimal removal of the pelvic tumor, often performed as en bloc recto-sigmoid resection with a sigmoidrectal anastomosis or with a colostomy. When performed in TC by surgeons with gynecological oncology training, the complication rates are shown to be acceptably low with anastomotic leak in 3-6% (27)(28)(29). Ideally, surgery for advanced disease should always involve at least one surgeon with gynecological oncological subspecialty training.…”

Cytoreductive Surgery and Peritonectomy Procedures

“…Several studies have shown that it does not increase the morbidity of CRS and not all cases require a diverting ileostomy. [63][64][65][66] When 10-15 cm of the rectum is preserved, an ileostomy can be avoided. Sugarbaker has described the technique of inverting the stapled anatamosis with a layer of interrupted silk sutures [67].…”