Ostomy Does Not Worsen Outcomes After Bowel Restrictions for Patients With Ovarian Cancer

Ostomy does not worsen survival outcomes after bowel resection compared with primary anastomosis among patients with ovarian cancer, new research results show.

While debulking cytoreduction surgery with bowel resection is a common ovarian cancer intervention, whether ostomy worsens survival outcomes and what factors physicians should consider when choosing which patients should undergo ostomy have been matters of controversy.

Studies note anastomotic leakage is a key complication associated with anastomosis because it can lead to abdominal inflammation, among other issues.

Ostomy is performed instead of primary anastomosis following bowel resection to prevent anastomotic leakage. Study results indicate that patients with a stoma who experience complications such as skin irritation prefer to avoid ostomy.

The researchers of the current study reviewed 763 studies published between 2016 and 2021 to determine whether ostomy among patients with ovarian cancer leads to worse outcomes after bowel resection compared with anastomosis and summarized possible indications for ostomy.

They focused on differences in the anastomotic leakage rate, length of hospital stay, overall survival, and other survival outcomes associated with primary anastomosis and ostomy.

The researchers found that “ostomy did not contribute to worse survival outcomes, and that the stoma-related complications were acceptable.” They also noted that indications for ostomy require further study, and bowel resection segment margins and the distance from the anastomosis to the anal verge require consideration.

Patient characteristics and surgery information should be considered before performing ostomy, the researchers noted.

Reference

He X, Li Z. Ostomy does not lead to worse outcomes after bowel resection with ovarian cancer: a systematic review. Front Oncol. Published online May 23, 2022. doi:10.3389/fonc.2022.892376