Extended left colon resections as part of complete cytoreduction for ovarian cancer.

Abstract

e15555 Background: Colectomy is a common part of cytoreductive surgery. The most common segment of the colon resected is the rectosigmoid. Extended left-sided colectomies are rarely performed. With increased emphasis on the importance of maximal cytoreductive surgery it is becoming more important to understand the outcomes related to such a procedure. The purpose of this report is to evaluate the quality of life issues related to extended left colectomies. Methods: Data on all patients who underwent cytoreductive surgery between April 2007 and April 2009 was prospectively recorded. 19 patients underwent extended left colon resections. The data from these cases was evaluated with particular attention directed at quality of life issues surrounding postoperative bowel function, and tolerance of postoperative chemotherapy. Results: 9 underwent resection of the left hemicolon plus the hepatic flexure. 6 underwent resection of the left hemicolon, hepatic flexure, and the ascending colon. 4 underwent subtotal colectomies. Temporary diverting loop ileostomies were performed on 18 of the 19 patients each of whom consented for intraperitoneal chemotherapy. No delays in chemotherapy were observed. Median number of bowel movements at 6, 9 and 12 months were 2, 2 and 1, respectively. No fecal incontinence was observed. Patients expressed satisfaction with their bowel surgery and denied any significant decrease in their quality of life due to their bowel function. A single chemotherapy cycle was delayed in 1 patient due to dehydration and electrolyte abnormalities. Each subsequent cycle was given on time with additional days of outpatient hydration. Conclusions: Extended left colon resection is a reasonable technique to include in patients requiring maximal cytoreduction. Quality of life related to bowel function is acceptable and patients express satisfaction with the degree of surgery. With attention to the additional hydration requirements needed after extended left colon resections, chemotherapy can be given on schedule and without delays No significant financial relationships to disclose.