Ovarian cancer patients who have their bowels removed as part of cytoreductive surgery (CRS) may benefit from a study looking into the aftereffects of this procedure using a combination of mechanical and oral antibiotic bowel preparation (MOABP). In this study, researchers analyzed data from 01/2011–12/2020 from a single hospital’s CRS procedures for ovarian cancer using ICD-10 diagnosis and procedure codes. Patients were categorized into 2 groups: those who had bowel resections and those who did not. To further categorize patients undergoing colon resection, they looked at whether they had MOABP or no bowel preparation. Researchers collected pre- and post-op data on the patient’s tumor and general health. The likelihood of postoperative complications 30 days after surgery was compared between patients who underwent bowel resection versus those who did not and between patients who underwent MOABP versus those who did not, using unadjusted and adjusted logistic regression. Out of the 919 people examined, 215 (23.3%) required bowel resection, and 81 (33.7%) were treated with MOABP. Similar demographic, comorbidity, and cancer information was found between patients who had MOABP and those who did not. Interval colonoscopy-directed resections were more common in MOABP patients (34.6% vs. 9.0%), as were optimal surgical resections (96.3% vs. 83.8%) and diverting ostomies (13.5% vs. 33.8%) and shorter hospital stays (7.1 vs. 9.4 days) than no bowel preparation patients. Adjusted analyses revealed that patients receiving MOABP were at a higher risk for unexpected ICU admissions, grade 3 or higher cardiac complications, and grade 3 or higher gastrointestinal complications but at a lower risk for deep/organ-space surgical infections and 30-day readmissions. Patients with ovarian cancer who received preoperative MOABP prior to colectomy, resection, and salvage (CRS) with colon resection had fewer deep/organ-space infections and readmissions, shorter hospital stays, fewer diverting ostomies, and higher rates of successful resections. However, these people also had a higher risk of deteriorating to a point where they needed to be admitted to an intensive care unit due to gastrointestinal or cardiac issues of grade 3 or higher. It’s crucial to weigh the good and bad postoperative outcomes in this patient group when making decisions in the clinic.
Source: sciencedirect.com/science/article/abs/pii/S0090825822003079
