Introduction/Background To investigate the factors related to non-reversal of ostomy after cytoreductive surgery in ovarian cancer patients. Rate and timing of stoma closure.

Methodology We reviewed data on 181 consecutive patients with ostomy formation during cytoreductive surgery for ovarian cancer at two different institutions (Institut Bergonie, France and University Hospital of Las Palmas, Spain) between January 2009 and December 2019. We did descriptive statistics and logistic regression models to evaluate the risk factors for non-reversal of stoma.

Results Ninety-two patients were included in final analysis. Restoration of the continuity of the gastrointestinal tract was achieved in 57 patients (62%). Mean time from ostomy creation to stoma closure was 47.7 weeks (±33.1). Hartmann’s procedure was identified as an independent predictive factor for non-reversal of ostomy [OR 6.42 (1.61–25.53), p=0.008]. Overall, complications within 30 days after reversal surgery occurred in 40% of the patients. Grade IIIB complications according to Clavien-Dindo occurred in 22.5% of the patients. No postoperative deaths were recorded.

Conclusion Hartmann´s procedure is a crucial limiting factor for stoma reversal due to complexity of reversal surgery. Thus, we recommend avoiding Hartmann´s procedure during cytoreductive surgery and even after colorectal anastomotic breakdown, if possible. Forthcoming guidelines for stoma formation and reversal should have into account this factor.

Disclosures All authors declare no conflict of interest.