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Does Ostomy Lead to Worse Outcomes in Ovarian Cancer after Bowel Resection? A Meta-analysis and Systematic Review
  • Xinlin He,
  • Zhengyu Li
Xinlin He
Sichuan University West China Second University Hospital
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Zhengyu Li

Corresponding Author:[email protected]

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Abstract

Background: Debulking cytoreduction surgery with bowel resection is a common intervention for ovarian cancer. Whether an ostomy should be performed remains controversial. Objectives: We performed a meta-analysis and systematic review to determine whether ostomy leads to poorer outcomes for ovarian cancer after bowel resection than anastomosis. Search Strategy: We searched PubMed Medline, Embase, and Cochrane for articles containing the phrase “ovarian cancer with bowel resection,” published between 2016 and 2021. Selecting Criteria: We included studies that compared primary anastomosis with ostomy. We mainly focused on differences in anastomotic leakage (AL) rate and some survival outcomes between the two procedures. Data Collection and Analysis: Review Manager V5.3 was used to analyze all studies. Main Results: Of all 763 studies, three were ultimately included in the meta-analysis (N=1411). Results showed that ostomy might not have more adverse events of Grade III and above (according to the Clavien–Dindo grade) ([Odds ratio] (OR) 1.04 (95% CI [0.82,1.33]). Moreover, ostomy might not increase AL(OR 1.07 (95% CI [0.30,3.87]). We have supplemented the systematic review to include analysis of those data which can not be analyzed by meta-analysis. Conclusion Ostomy may not result in more AL, but may lead to worse survival outcomes than anastomosis. However, patients with a more severe ovarian cancer status may be more prone to ostomy rather than primary anastomosis. Funding: This work was supported by the Sichuan Province Science and Technology Support Program (grant number 2019YJ0072). Keywords: Ostomy, Ovarian Cancer, Bowel Resection, Meta-analysis, Systematic Review