Patient selection: women with ovarian cancer undergoing rectosigmoid colectomy for optimum tumor debulking.
Risk factors associated with anastomotic leakage:
(1) preoperative serum albumin < 3 g/dL
Additional risk factors mentioned by other authors:
(1) history of pelvic irradiation (not a risk factor in this study but the number of irradiation patients was small; recent or high dose radiation therapy might be a problem)
(2) starting chemotherapy before healing has occurred
(3) cigarette smoking
where:
• Women with ovarian cancer tend to receive chemotherapy rather than radiation therapy.
• The bowel that needs to be removed is within the peritoneal cavity. Thus the distance to the anal verge is not as much of an issue as it is with colorectal cancer.
Implications:
(1) A woman with a low serum albumin may be a candidate for diverting stomas.
(2) Since hypoalbuminemia may be a marker of protein malnutrition, enhanced nutrition may be of benefit.
(3) A woman with an anastomosis should be monitored for signs of an anastomotic leak (3% of women at low risk developed a leak)
