J Gynecol Oncol.  2020 Jan;31(1):e3. 10.3802/jgo.2020.31.e3.

Well-trained gynecologic oncologists can perform bowel resection and upper abdominal surgery safely

• Nishikimi
• Tate S
• Kato K
• Matsuoka A
• Shozu M

• KMID: 2500402
• DOI: http://doi.org/10.3802/jgo.2020.31.e3

Abstract

Objective
This study was performed to examine the safety of bowel resection and upper abdominal surgery in patients with advanced ovarian cancer performed by gynecologic oncologists after training in a monodisciplinary surgical team.
Methods
We implemented a monodisciplinary surgical team consisting of specialized gynecologic oncologist for advanced ovarian cancer. In the initial learning period in 65 patients with International Federation of Gynecology and Obstetrics (FIGO) III/IV, a gynecologic oncologist who had a certification as a general surgeon trained 2 other gynecologic oncologists in bowel resection and upper abdominal surgery for 4 years. After the initial learning period, the trained gynecologic oncologists performed surgeries without the certificated general surgeon in 195 patients with FIGO III/IV. The surgical outcomes and perioperative complications during the 2 periods were evaluated.
Results
The rates of achieving no gross disease after cytoreductive surgery were 80.0% in the initial learning period and 83.6% in the post-learning period (p=0.560). The incidence of anastomotic leakage after rectosigmoid resection, symptomatic pleural effusion or pneumothorax after right diaphragm resection, and pancreatic fistula after splenectomy with distal pancreatectomy in the 2 periods were 2 of 34 (6.0%), 1 of 33 (3.0%), and 3 of 15 (20.0%) patients in the initial learning period, and 12 of 147 (8.2%), 1 of 118 (0.8%), and 11 of 84 (13.1%) patients in the post-learning period, respectively. There were no significant differences between the 2 groups (p=0.270, p=0.440, p=0.520, respectively).
Conclusion
Bowel resection and upper abdominal surgery can be performed safely by gynecologic oncologists.

Keyword

Ovarian Neoplasms; Cytoreduction Surgical Procedures; Postoperative Complications