Introduction/Background Anastomotic leak remains the main concern after colorectal anastomosis in ovarian cancer. Our objective was to compare the use of three different management approaches after colorectal resection and anastomosis in patients with ovarian cancer.

Methodology Patients who underwent colorectal resection during cytoreduction for FIGO stage II–IV ovarian cancer were identified (n 273). Those with terminal colostomy were excluded (n 22).

We compared 2 time periods with different diversion stoma policy: non-restrictive stoma use (2010–2018) vs restrictive stoma use (2018–2023) for colorectal anastomosis protection.

Univariate analyses were performed for qualitative variables by using the χ2 test or Fisher’s test.

Results A total of 252 patients were identified: 133 (52.7%) in the non-restrictive group and 119 (47.3%) in the restrictive group. The rate of procedures per year was 16.6/yy for the non restrictive group vs 24.8/yy for the restrictive group. There was no differences in the rate of anastomotic leak between both groups (5.2% vs 3.3%; p=0.117). Regarding the the approach followed after colorectal anastomosis, patients were stratified into three groups. Statistic differences were found in the rate of conservative management and observation (55%vs11%; p< 0.00001), diverting ileostomy (13%vs6%; p< 0.00001) and ghost ileostomy technique (32%vs83%; p< 0.00001).

Conclusion The implementation of a restrictive stoma policy based on the use of ghost ileostomy leads to a decrease in the use of diversion ileostomy without increasing the rate of anastomotic leakage.

Disclosures None