Introduction/Background Hudson first described the procedure that includes en-block removal of ovarian tumor fixed in the pelvis with the whole of the pelvic peritoneum and invaded surrounding structures. However, sometimes shaving of the rectosigmoid serosa with the removal of the peritoneum of the entire pouch of Douglas is not enough to achieve complete debulking and en-block rectosigmoid removal (modified Hudson) is needed. This study aims to investigate the impact of bowel surgery on the survival of patients with advanced ovarian cancer, where otherwise zero residual disease would not be possible.

Methodology We retrospectively analyzed the records of patients with advanced ovarian cancer with rectosigmoid disease that underwent debulking surgery in the 1st Department of Obstetrics – Gynecology Clinic from 2017 – 2022. Patient characteristics, oncological and follow-up information were collected. The primary outcome were the progression free and overall survival rates between serosa shaving and resection of the rectosigmoid.

Results 93 patients met the inclusion criteria to be included in the final analysis. Patients were categorized into two groups: Group A (34 patients) rectosigmoid resection and Group B (59 patients) shaving serosa of rectosigmoid. There was no statistically significant difference in age, BMI, comorbidities, CA-125 pre-operative value and intraoperative blood loss between the two groups. On the other hand, patients with rectosigmoid resection had a significant higher surgery duration, ICU admission, rate of postoperative complications and hospital stay. When comparing the type o surgery, rectosigmoid resection was significant higher during primary compared to interval debulking surgery. Concerning survival rates, there was no significant difference in progression-free (p=0.22) and overall survival (p=0.85) between resection and shaving of the rectosigmoid.

Conclusion The modified Hudson procedure with the en-block resection of the rectosigmoid, when the bowel cannot be spared compared with shaving of the serosa is a safe and reproducible technique to achieve complete cytoreduction.

Disclosures No disclosures.