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132 Propensity score matched comparison of rectosigmoid mesorectal-sparing resection and total mesorectal excision in advanced ovarian cancer surgery: an accredited ESGO center experience
  1. Chiara Paglietti1,
  2. Stefano Restaino2,
  3. Martina Arcieri2,
  4. Federica Perelli3,
  5. Luca Pace4,
  6. Jessica Mauro1,
  7. Sara Pregnolato1,
  8. Giulia Pellecchia1,
  9. Alice Poli1,
  10. Elisa Maisto4,
  11. Roberta Massobrio4,
  12. Margherita Giorgi4,
  13. Alessandro Buda5,
  14. Alberto Mattei3,
  15. Luca Giuseppe Sgro6,
  16. Annamaria Ferrero4,
  17. Lorenza Driul1 and
  18. Giuseppe Vizzielli1
  1. 1Medical Area Department, Clinic of Obstetrics and Gynecology, ‘Santa Maria della Misericordia’ University Hospital, Udine, Italy
  2. 2Department of Maternal and Child Health, ‘Santa Maria della Misericordia’ University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
  3. 3Division of Gynaecology and Obstetrics, Santa Maria Annunziata Hospital, USL Toscana Centro, Florence, Italy
  4. 4University of Turin, Department of Surgical Sciences, Torino, Italy
  5. 5Michele e Pietro Ferrero Hospital, Verduno, Italy
  6. 6Obstetrics and Gynecology University Department, Mauriziano Umberto I Hospital, Torino, Italy

Abstract

Introduction/Background Complete cytoreductive surgery with achievement of no residual disease is the recommended treatment in advanced epithelial ovarian cancer (AEOC), with rectosigmoid resection being one of the most frequently performed surgical procedures. Total mesorectal excision (TME) is the traditional technique used for resection in rectal cancer, as removing mesorectal tissues results in lower rates of local recurrence. Recently, a TME technique with mesorectal sparing (i.e.: MS-TME) has emerged to reduce the risks of anastomotic leakage and potentially local infection. However, limited data are available on the feasibility and safety of this technique in cytoreductive surgery for AEOC.

Methodology AEOC women who underwent MS-TME were enrolled at Obstetrics and Gynecology Clinic of the University Hospital of Udine, ESGO-accredited for ovarian cancer surgery. A propensity match was performed with AEOC patients submitted to standard TME.

Clinical and surgical features, postoperative complications, overall-survival, and progression-free survival (PFS) data were recorded. Descriptive statistics were used to characterize the patient population and the type of intestinal surgery. The perioperative outcomes were analysed using the Mann-Whitney test or chi-square test. To evaluate the risk of anastomotic leakage, univariate and multivariable analyses with logistic regression were performed to control for potential confounding variables. Differences were considered statistically significant at p < 0.05

Results 80 patients were enrolled, 40 underwent TME, and 40 had MS-TME surgery. The incidence of intra-operative transfusion, operative time, pelvic recurrence rate, and PFS resulted in no statistical differences between the two groups. However, patients who underwent MS had fewer anastomotic leakage events (p < 0.05); we evaluated, as risk factors for anastomotic leakage, postoperative hemoglobin level, and surgery type (TME) in the univariate analysis. In multivariate analysis, only postoperative hemoglobin level remained an independent risk factor

Conclusion MS-TME rectosigmoid resection appears to be a feasible and safe technique in patients with AEOC with pelvic peritoneal involvement.

Disclosures All authors declare no conflicts of interests.

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