| Objective: There are limited studies on transitory protective stoma(TPS)in primary debulking surgery(PDS)in patients with ovarian cancer(OC).The purpose of this study was to investigate the application,postoperative effect and benefit of TPS in PDS of patients with OC.Methods: This study retrospectively analyzed patients with FIGO stage III-IV OC who underwent colorectal resection and TPS in PDS in Shengjing Hospital of China Medical University from January 2018 to March 2022.According to the results of PDS and the application of TPS,the patients were divided into three groups: group A was PDS with R0,and TPS was performed after colorectal anastomosis;group B was PDS with R0,and no TPS was performed after colorectal anastomosis;group C was PDS with R1,and no enterectomy was performed.The general clinical features,surgical features,postoperative recovery effect and complications of the patients were collected and statistically analyzed.Results: A total of 84 eligible patients were collected.They included 25(29.8%)in group A,22(26.2%)in group B,and 37(44.0%)in group C.There was no difference in patients’ baseline characteristics.The operation time of the three groups was 283 minutes,266 minutes and 236 minutes,respectively.Group A had longer surgery than the other two groups(P=0.003)and underwent more rectosigmoid excision(56%,P=0.036).The first feeding time of the three groups was 1 day,7 days and 3 days,respectively.Exhaust time was 3 days,6 days and 3 days,respectively.The difference was statistically significant(P<0.001).There was no significant difference in the time of feeding(P=0.07)and exhausting(P=1.00)between group A and group C,but earlier than group B(P<0.001).The first normal time(P=0.139)and half-life(P=0.199)of CA125 in group A and group B were not significantly different,but both were better than those in group C(P<0.001).The first time of chemotherapy after surgery was 8 days,18.5 days and 17 days,respectively,and the difference was statistically significant(P<0.001).The duration of first chemotherapy in group A was significantly shorter than that in groups B and C(P<0.001).Intestinal surgery in groups A and B up to R0 was necessary and reduced the rate of disease progression by 56.8% compared with group C in R1.Compared with groups A and B,the use of TPS reduced the likelihood of disease progression by 95.3%.There was no significant difference between the three groups in overall complications and 30-day readmission rate.There were no significant differences between the three groups in assessing quality of life in four areas: physical health,mental health,social relationships and the surrounding environment.But overall quality of life assessments were significantly lower in the R1 excision group than in the other two groups.Conclusion: The application of TPS in the PDS of OC patients can accelerate postoperative recovery and ensure the timely initiation of postoperative chemotherapy,reduce the risk and speed of disease progression in patients,and limit the occurrence of adverse complications.TPS did not increase the surgical pressure and hospital costs of patients,and did not significantly affect the quality of life of patients. |
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