Valenti et al reported predictors for anastomotic leakage after bowel resection in a woman with advanced ovarian cancer. These can help to identify a patient who may benefit from a draining colostomy. The authors are from multiple institutions in Italy and England.
Patient selection: advanced ovarian or related (fallopian tube, etc) cancer
Frequency of anastomotic leak: 4-7%
Anastomotic leakage can result in delay in adjuvant chemotherapy, which can adversely affect survival.
Predictors of anastomotic leakage:
(1) pre-operative serum albumin concentration <= 3 g/dL (OR 5.3)
(2) multiple bowel resections (OR 4.4), presumably related to the cancer
(3) primary cytoreductive surgery (OR 1.7)
where:
• Would no previous bowel resections indicate primary cytoreductive surgery?
Factors not predictive:
(1) ASA score
(2) presence of ascites
(3) optimal cytoreduction
(4) protective stoma
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