Highlights
- •MOABP prior to bowel resection at ovarian cancer CRS was associated with lower deep/organspace SSI and readmissions.
- •MOABP prior to bowel resection was associated with higher odds of ICU admissions and grade ≥ 3 cardiac and GI complications.
- •MOABP prior to bowel resection may be associated with shorter hospital stays and more optimal resections.
Abstract
Objectives
To examine postoperative complications associated with preoperative mechanical and
oral antibiotic bowel preparation (MOABP) for patients with ovarian cancer who underwent
bowel resection at cytoreductive surgery (CRS).
Methods
This was a single-institution retrospective study of patients with ovarian cancer
undergoing CRS from 01/2011–12/2020 using ICD-10 diagnoses and procedure codes. Patients
were stratified by those who underwent bowel resection versus no resection. Bowel
resection patients were further stratified by those who underwent MOABP versus no
bowel preparation. Patient demographics, tumor data, and perioperative metrics were
collected. Unadjusted and adjusted logistic regression evaluated odds of 30-day postoperative
complications in patients with bowel resection versus no resection and those with
MOABP versus no bowel preparation.
Results
Of 919 patients identified, 215 (23.3%) required bowel resection, which included 81
(37.7%) who received MOABP. Patient characteristics, co-morbidities, and cancer data
were similar between MOABP versus no bowel preparation patients. MOABP patients underwent
more interval CRS (34.6% versus 9.0%), more optimal surgical resections (96.3% versus
83.8%), fewer diverting ostomies (13.5% versus 33.5%), and shorter hospital stays
(7.1 versus 9.4 days) than no bowel preparation patients. On adjusted analyses, MOABP
patients experienced significantly lower odds of deep/organ-space surgical infections
and 30-day readmissions but higher odds of unplanned intensive care unit (ICU) admissions
and grade 3 or higher cardiac and gastrointestinal complications.
Conclusions
Patients who underwent preoperative MOABP prior to ovarian cancer CRS with bowel resection
had lower odds or deep/organ-space infections and readmissions, shorter hospital stays,
fewer diverting ostomies, and more optimal resections. However, these patients also
experienced higher odds of ICU admissions and grade 3 or higher cardiac and gastrointestinal
complications. The positive and negative postoperative outcomes in this population
should be considered in clinical practice.
Keywords
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Article info
Publication history
Published online: May 16, 2022
Accepted:
May 8,
2022
Received in revised form:
May 3,
2022
Received:
March 27,
2022
Footnotes
☆Abstract presented at The Society of Gynecologic Oncology 2022 Winter Meeting, Jan. 27-29, 2022, Olympic Valley, CA, USA.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
