RECTOSIGMOID COLECTOMY AND REANASTOMOSIS TO FACILITATE RESECTION OF PRIMARY AND RECURRENT GYNECOLOGIC CANCER

  • 1 January 1984
    • journal article
    • research article
    • Vol. 64  (5) , 715-720
Abstract
From 1976 through 1972, 72 rectosigmoid colectomies were performed on patients treated at a gynecologic oncology service. Of these, 35 were performed to resect primary or recurrent ovarian cancer, and 37 were performed as part of an exenteration for recurrent cervical or vaginal carcinoma. In 24 of the patients with ovarian cancer and 11 of the patients undergoing exenteration, the rectosigmoid colon was primarily reanastomosed, using either a primary suture technique or the end-to-end anastomosis stapler. Intraoperative management included adequate mobilization of the colonic mesentery to eliminate tension on the anastomosis, and liberal use of pelvic drains. Eighteen of 24 patients (75%) with ovarian cancer who received a primary reanastomosis did not have a protecting colostomy, whereas all 11 patients who underwent exenteration had a protecting colostomy. There were no anastomotic leaks in any of these patients, although morbidity occurred in 7 of 35 patients (20%). There were no operative mortalities. The end-to-end anastomosis stapler has facilitated lower resections with primary reanastomosis. Colostomy is not mandatory in patients who have not had prior pelvic radiation therapy, and in whom no pelvic infection exists. Rectosigmoid colectomy permitted optimal or curative tumor resection in the majority of these patients, and thus could be performed whenever necessary to accomplish this goal.