J Gynecol Oncol | Volume 3, Issue 4 | Research Article | Open Access
Hannah Elkadi1, Melissa Bradbury1,2, Rachel L O’Donnell1,3,4* and Raj Naik1
1Department of Gynecological Oncology, Queen Elizabeth Hospital, UK
2Department of Gynecological Oncology, Vall d’Hebron Hospital, Spain
3Translational and Clinical Research Institute, Newcastle University, UK
4Department of Gynecological Oncology, Newcastle Upon Tyne Foundation Trust, Royal Victoria Infirmary, UK
*Correspondance to: Rachel L O’Donnell
Fulltext PDFBackground: This observational study describes an extended cohort, from a single surgeon, reporting indications, technique and morbidity for a novel trans-ureteric approach to stent placement. Methods: This retrospective observational study included all patients who underwent cytoreductive surgery, 2001 to 2017, with intra-operative stent insertion. Clinicopathological data, stent indication and morbidities were collated. Results: 2,195 patients underwent laparotomy for ovarian cancer in the 16-year study period, of which 42 (2%) underwent intra-operative stent insertion. Indications included persistent hydroureter despite surgical decompression (15, 36%), prophylactically following extensive ureterolysis with concerns of post-operative ischemia/fistula formation (12, 29%), ureteric stricture (6, 14%), following partial ureteric excision to facilitate cytoreduction (6, 14%) or inadvertent injury (3, 7%). Complete, or near-optimal, surgical cytoreduction was achieved in 32 (76%) patients. All stents were inserted by a gyne-oncologist with no failed insertions and no stent-related complications. Conclusion: Intra-operative trans-ureteric stenting by a gyne-oncologist is feasible, safe, can protect devascularized ureters after extensive retroperitoneal dissection and may serve to reduce perioperative urological morbidity whilst allowing a more aggressive cytoreductive surgical approach.
Ureteric stent; Ovarian cancer; Cytoreductive surgery; Trans-ureteric approach
Hannah E, Melissa B, O’Donnell RL, Raj N. Intra-Operative Trans-Ureteric Stent Insertion during Cytoreductive Surgery for Ovarian Cancer: Update of a Novel Technique. J Gynecol Oncol. 2020; 3(4): 1039.