Abstract：
BACKGROUND: This report describes the oncologic outcomes for patients with advanced ovarian cancer who had bowel surgery performed by gynecologic oncologists (GOs) and compares the outcomes with those for bowel surgery performed by general surgeons (GSs) during maximal cytoreductive surgery.
METHODS: Patients from six academic institutions who had FIGO stage III or IV ovarian cancer and underwent any bowel surgeries during maximal cytoreductive surgery were eligible for the study. The patients were divided into two groups according to whether bowel surgery was performed by a GO or a GS. In both groups, the GOs were mainly involved in extra bowel debulking procedures. Perioperative and survival outcomes were compared between the two groups.
RESULTS: The 761 patients in this study included 113 patients who underwent bowel surgery by a GO and 648 who had bowel surgery by a GS. No discernible differences were observed in age, American Society of Anesthesiology (ASA) score, FIGO stage, histologic type, timing of cytoreductive surgery (primary or interval debulking surgery), or complications between the two groups. The GO group exhibited a shorter operation time than the GS group. Kaplan-Meier analysis showed no survival differences between the two groups. In the Cox analysis, non-serous cell types and gross residual diseases were associated with adverse effects on overall survival. However, performance of bowel surgery by a GO did not have an impact on survival.
CONCLUSIONS: Performance of bowel surgery by a GO during maximal cytoreductive surgery is both feasible and safe. These results should be reflected in the training system for GOs regarding bowel surgery, and further research is needed to confirm that GOs can play a more leading role in performing extra-uterine procedures.
METHODS: Patients from six academic institutions who had FIGO stage III or IV ovarian cancer and underwent any bowel surgeries during maximal cytoreductive surgery were eligible for the study. The patients were divided into two groups according to whether bowel surgery was performed by a GO or a GS. In both groups, the GOs were mainly involved in extra bowel debulking procedures. Perioperative and survival outcomes were compared between the two groups.
RESULTS: The 761 patients in this study included 113 patients who underwent bowel surgery by a GO and 648 who had bowel surgery by a GS. No discernible differences were observed in age, American Society of Anesthesiology (ASA) score, FIGO stage, histologic type, timing of cytoreductive surgery (primary or interval debulking surgery), or complications between the two groups. The GO group exhibited a shorter operation time than the GS group. Kaplan-Meier analysis showed no survival differences between the two groups. In the Cox analysis, non-serous cell types and gross residual diseases were associated with adverse effects on overall survival. However, performance of bowel surgery by a GO did not have an impact on survival.
CONCLUSIONS: Performance of bowel surgery by a GO during maximal cytoreductive surgery is both feasible and safe. These results should be reflected in the training system for GOs regarding bowel surgery, and further research is needed to confirm that GOs can play a more leading role in performing extra-uterine procedures.
摘要：
背景：本报告描述了由妇科肿瘤学家（GO）进行肠道手术的晚期卵巢癌患者的肿瘤学结果，并将其结果与在最大细胞减灭术中由普通外科医生（GS）进行的肠道手术的结果进行了比较。
方法：来自六个学术机构的患有FIGOIII或IV期卵巢癌并在最大细胞减灭术期间接受任何肠道手术的患者符合研究条件。根据是通过GO还是GS进行肠道手术，将患者分为两组。在这两组中,GOs主要参与肠外减压手术。比较两组患者围手术期及生存结果。
结果：本研究中的761例患者包括113例接受GO肠手术的患者和648例接受GS肠手术的患者。在年龄上没有观察到明显的差异，美国麻醉学会（ASA）评分，FIGO阶段，组织学类型，细胞减灭术的时机（初级或间隔减积手术），或两组之间的并发症。GO组的手术时间短于GS组。Kaplan-Meier分析显示两组之间无生存差异。在Cox分析中,非浆液细胞类型和大体残留疾病与对总生存期的不利影响相关.然而,通过GO进行肠道手术对生存率没有影响.
结论：在最大细胞减灭术中通过GO进行肠道手术既可行又安全。这些结果应反映在GOs有关肠道手术的培训系统中，需要进一步的研究来确认GO在进行子宫外手术中可以发挥更多的主导作用。
方法：来自六个学术机构的患有FIGOIII或IV期卵巢癌并在最大细胞减灭术期间接受任何肠道手术的患者符合研究条件。根据是通过GO还是GS进行肠道手术，将患者分为两组。在这两组中,GOs主要参与肠外减压手术。比较两组患者围手术期及生存结果。
结果：本研究中的761例患者包括113例接受GO肠手术的患者和648例接受GS肠手术的患者。在年龄上没有观察到明显的差异，美国麻醉学会（ASA）评分，FIGO阶段，组织学类型，细胞减灭术的时机（初级或间隔减积手术），或两组之间的并发症。GO组的手术时间短于GS组。Kaplan-Meier分析显示两组之间无生存差异。在Cox分析中,非浆液细胞类型和大体残留疾病与对总生存期的不利影响相关.然而,通过GO进行肠道手术对生存率没有影响.
结论：在最大细胞减灭术中通过GO进行肠道手术既可行又安全。这些结果应反映在GOs有关肠道手术的培训系统中，需要进一步的研究来确认GO在进行子宫外手术中可以发挥更多的主导作用。
