Introduction/Background In advanced ovarian cancer (aOVCa), debulking surgery often involves diverting ileostomy (IL) alongside bowel resection for complete tumor removal. IL can lead to complications, including dehydration, which may jeopardize renal function. We conducted a retrospective study to assess the short- and long-term impact of IL on renal function in these patients.

Methodology We reviewed patients with newly diagnosed aOVCa who underwent debulking surgery with bowel resection and post-operative platinum chemotherapy (Cx) across four affiliated institutions between April 2012 and March 2022. Using propensity score, we paired cases between IL and non-IL groups based on age, stage, CA125, histological subtype, primary or interval debulking surgery, and residual tumor status. Renal function was assessed using estimated glomerular filtration rate (eGFR, mL/min/1.73m2) at several time points, including baseline, post-surgery, after the third Cx cycle, and 1–3 and 7–12 months after the last Cx dose.

Results Of the 215 eligible patients, 66 were successfully matched in each group. Baseline eGFR values were comparable (IL: 79.5 vs. non-IL: 80.2, p = 0.8). In the short term, eGFR at 1–3 months post-Cx was significantly lower in the IL group compared to the non-IL group (IL: 59.5 vs. non-IL: 73.8, p < 0.001). In the long term, eGFR at 7–12 months post-Cx was also significantly lower in the IL group (IL: 56.6 vs. non-IL: 70.5, p < 0.001). Additionally, the IL group exhibited a higher prevalence of chronic kidney disease (CKD) classification G3 or higher (IL: 63.8% vs. non-IL: 30.2%, p = 0.003). Among the 35 patients who underwent IL reversal, there was no significant change in eGFR.

Conclusion IL is associated with an increased risk of renal impairment, potentially leading to CKD. IL reversal does not appear to significantly improve it.

Disclosures I certify that all my affiliations or financial involvement with any organization or financial conflict with the subject matter discussed in the manuscript are completely disclosed in the acknowledgement section of the manuscript.