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Intestinal surgery in gynecologic oncology.
S C Rubin1, I Benjamin, W J Hoskins
1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York 10021.
Gynecologic Oncology
|July 1, 1989
Summary
Gynecologic cancer patients often require intestinal surgery for complications like obstruction or fistula. These complex procedures, including resections and colostomies, can be performed safely, even in previously irradiated patients.
Area of Science:
- Oncology
- Surgical Gastroenterology
- Gynecologic Oncology
Background:
- Intestinal surgery is a common necessity in managing gynecologic malignancies.
- A significant percentage of laparotomies in gynecologic cancer patients involve major intestinal procedures.
Purpose of the Study:
- To analyze the scope and outcomes of intestinal surgery in patients with gynecologic cancer.
- To evaluate the safety and feasibility of these procedures within a fellowship training program.
Main Methods:
- Retrospective review of 171 operations involving 158 gynecologic cancer patients over a 3-year period.
- Detailed analysis of indications, procedures performed (resections, bypasses, colostomies, urinary diversions), and surgical techniques (hand suturing vs. stapling).
Main Results:
- 215 intestinal procedures were performed, most commonly for ovarian, cervical, and endometrial cancers.
- Indications included intestinal obstruction (43.2%) and fistula (21%).
- Complications were infrequent, with a single surgical mortality, even in 46.2% of previously irradiated patients.
Conclusions:
- Major intestinal surgery in gynecologic cancer patients is safe and associated with low morbidity and mortality.
- Fellowship training programs can successfully manage these complex cases.
- Clinicians must possess both surgical skills and a deep understanding of gynecologic malignancies and their intestinal complications.