1. Rectosigmoid resection by gynecologic oncologists versus colorectal surgeons: as long as it catches the mouse, does the color of the cat matter?
- Author
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Federico Ferrari, Roberto Tozzi, Massimo Cristaldi, Riccardo Garruto Campanile, Gaetano Valenti, and Daniele Vinti
- Subjects
medicine.medical_specialty ,Genital Neoplasms, Female ,MEDLINE ,Gynecologic oncology ,Anastomosis ,03 medical and health sciences ,Mice ,0302 clinical medicine ,medicine ,Animals ,Humans ,Stage IIIC ,Rectosigmoid resection ,Stage (cooking) ,Neoplasm Staging ,Oncologists ,Surgeons ,Ovarian Neoplasms ,030219 obstetrics & reproductive medicine ,business.industry ,Mortality rate ,General surgery ,Ovary ,Obstetrics and Gynecology ,General Medicine ,Cytoreduction Surgical Procedures ,Debulking ,medicine.disease ,Surgery ,Ovarian Cancer ,Editorial ,Oncology ,030220 oncology & carcinogenesis ,Cats ,Original Article ,Female ,Morbidity ,Colorectal Neoplasms ,Genital Neoplasms ,Ovarian cancer ,business ,Gynecologic Oncologist ,Colorectal surgeons - Abstract
Objective This study investigates the specific morbidity of rectosigmoid resection (RSR) during Visceral-Peritoneal Debulking (VPD) in a consecutive series of patients with stage IIIC-IV ovarian cancer and compares the results of the colo-rectal vs. the gynaecologic oncology team. Methods All patients with the International Federation of Gynecology and Obstetrics (FIGO) stage IIIC–IV ovarian cancer who had VPD and RSR were included in the study. Between 2009 and 2013 all operations were performed by the gynecologic oncology team alone (group 1). Since 2013 the RSR was performed by the colorectal team together with the gynecologic oncologist (group 2). All pre-operative information and surgical details were compared to exclude significant bias. Intra- and post-operative morbidity events were recorded and compared between groups. Results One hundred and sixty-two patients had a RSR during VPD, 93 in group 1 and 69 in group 2. Groups were comparable for all pre-operative features other than: albumin (12). Overall morbidity was 33% vs. 40% (p=0.53), bowel specific morbidity 11.8% vs. 11.5% (p=0.81), anastomotic leak 4.1% vs. 6.1% (p=0.43) and re-operation rate 9.6% vs. 6.1% (p=0.71) in groups 1 and 2, respectively. None of them were significantly different. The rate of bowel diversion was 36.5% in group 1 vs. 46.3% in group 2 (p=0.26). Conclusions Our study failed to demonstrate any significant difference in the morbidity rate of RSR based on the team performing the surgery. These data warrant further investigation as they are interesting with regards to education, finance, and medico-legal aspects.
- Published
- 2021