Understanding Complications of Surgery
- A large open debulking surgery can be common for women with advanced stage ovarian cancer
- Some patients may require a bowel resection
- While infections and other complications are possible, the outcomes are often positive for ovarian cancer
“One of the most common complications occurs when there’s bowel involvement,” says Dr. Gillian Hsieh, gynecologic oncologist at Sutter Bay Medical Foundation in the San Francisco Bay Area. “Sometimes we have to do bowel resections, which involves removing a segment of bowel and reconnecting the bowel back together, called anastomosis.”
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Solutions for Bowel Involvement
If your disease has spread to the abdomen, and your surgery involves removing portions of the bowel, your doctor may insert an ostomy bag to relieve the stool.
“One of the most feared complications of anastomosis is something called anastomotic leak where the anastomosis doesn’t heal well and there’s stool spillage into the abdomen causing patients to become very sick,” explains Dr. Hsieh. This leak can lead to a life-threatening condition called sepsis.
Sepsis requires patients to return to the operating room where doctors will reopen their incision for a procedure called a diverting ostomy. “We pull up a knuckle of the intestine that comes before where the stool would have passed through and divert it outside of the abdomen into an ostomy bag,” Dr. Hsieh says. The procedure allows time for the newly reconnected segment to heal.
The good news: In most cases, the need for an ostomy bag is temporary. Once you recover from the procedure, your bowel will likely resume normal functioning. “We usually keep the ostomy bag until patients finish chemotherapy,” Dr. Hsieh says.
Other Surgical Complications
About half of women experience a complication related to ovarian cancer surgery. The chances of complications following surgery depend on a number of factors, including your age, extent of disease, and whether you have unrelated health conditions.
Complications could be something as minor as a blood transfusion, or something more major like a blood clot. In any case, it is common for patients who undergo ovarian cancer surgery to require additional medical interventions. A few of the more common include:
- Incontinence: If your bladder is affected, your doctor may place a thin tube called a catheter in your bladder to remove urine. Catheters are usually temporary and they remain in place until your bladder resumes normal functioning.
- A blood transfusion: Up to 50 percent of ovarian cancer patients need a blood transfusion during surgery, which increases the risk of infection.
- Treatment in the Intensive Care Unit (ICU): Most patients, particularly those who receive a blood transfusion, will require treatment in the ICU to assist with their recovery after surgery.
- Overnight intubation: You may wake up with a tube down your throat and you’ll likely remain in the hospital for several days following the procedure so doctors can easily manage your pain level and monitor your recovery.
Unfortunately, ovarian cancer surgery can also increase the risk of blood clots and put pressure on the heart and other organs. Patients who develop an infection after surgery also require longer hospital stays, which can be complicated during the coronavirus pandemic.
While most ovarian cancer requires extensive surgery, your doctor will perform the procedure that will remove as much disease as possible while minimizing side effects and preserving quality of life.
Concerned about your odds of facing a bowel resection or other complication? Talk to your doctor. Every ovarian cancer surgery is different, and it’s important to make sure you’re having the procedure that with the best chance of success for your unique case.
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