Surgical management of anastomotic leakage related to ovarian cancer surgery: a narrative review

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2024-09-11 DOI:10.3389/fsurg.2024.1434730

Stefano Restaino, Sofia Schierano, Martina Arcieri, Barbara Costantini, Alice Poli, Sara Pregnolato, Giovanni Terrosu, Sergio Calandra, Marco Petrillo, Giulia Pellecchia, Alessandro Lucidi, Marko Klarić, Lorenza Driul, Vito Chiantera, Alfredo Ercoli, Cristina Taliento, Francesco Fanfani, Anna Fagotti, Giovanni Scambia, Giuseppe Vizzielli

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引用次数: 0

Abstract

This narrative review describes the state of the art in the management of anastomotic leakage in ovarian cancer. Multiple surgical procedures, including bowel resection, are often required to achieve “optimal” cytoreduction in locally advanced ovarian cancer. Intestinal anastomosis is currently the most common way to restore bowel continuity. However, in some patients, a temporary protective stoma is indicated to prevent anastomotic leakage. This is an important issue to improve surgical outcomes and until recently there has been a lack of objective data to clarify the risk factors for anastomotic leakage. This review describes the risk factors for AL associated with surgery and compares the results of recent studies. We also review the current indications for placement of a protective ileostomy and treatment options for conservative management of AL. We present two examples of practical clinical AL risk calculators, in addition to the most assessed AL risk factor. To date, the decision-making processes that lead surgeons to perform a protective ileostomy are quite heterogeneous and based on the personal experience of the surgeon, mainly depending on individual training. Three different management options after colorectal anastomosis in OC are described: conservative management, diversion ileostomy and ghost ileostomy.

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与卵巢癌手术相关的吻合口漏的外科处理：叙述性综述

这篇叙述性综述介绍了卵巢癌吻合口漏的最新治疗技术。局部晚期卵巢癌患者通常需要进行包括肠道切除在内的多种手术，才能达到 "最佳 "的细胞减灭术。肠吻合术是目前恢复肠道连续性最常用的方法。然而，有些患者需要临时保护性造口，以防止吻合口渗漏。这是改善手术效果的一个重要问题，但直到最近，仍缺乏客观数据来明确吻合口漏的风险因素。本综述描述了与手术相关的 AL 风险因素，并比较了近期的研究结果。我们还回顾了目前放置保护性回肠造口术的适应症以及保守治疗 AL 的治疗方案。除了评估最多的 AL 风险因素外，我们还介绍了两种实用的临床 AL 风险计算器。迄今为止，导致外科医生实施保护性回肠造口术的决策过程是多种多样的，主要基于外科医生的个人经验和个人培训。本文介绍了 OC 结肠直肠吻合术后的三种不同处理方案：保守处理、转流回肠造口术和幽闭回肠造口术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.