GYNECOLOGY

Side-to-end reanastomosis after low-anterior resection (STELAR): Outcomes, feasibility, and description of procedure performed by a gynecologic oncology service

Varun U. Khetan MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Laila I. Muderspach MD,

Laila I. Muderspach MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Heather A. Miller MD,

Heather A. Miller MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Ernesto Licon MD,

Ernesto Licon MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Crystal L. Adams MD,

Crystal L. Adams MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Laurie L. Brunette MD,

Laurie L. Brunette MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Huyen Q. Pham MD,

Huyen Q. Pham MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Annie A. Yessaian MD,

Annie A. Yessaian MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Lynda D. Roman MD,

Lynda D. Roman MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA

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Koji Matsuo MD, PhD,

Corresponding Author

Koji Matsuo MD, PhD

[email protected]

orcid.org/0000-0002-6232-8701

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA

Correspondence: Koji Matsuo, MD, PhD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Ave IRD 520, Los Angeles, CA 90033, USA.

Email: [email protected]

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Marcia A. Ciccone MD,

Marcia A. Ciccone MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Varun U. Khetan MD,

Varun U. Khetan MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Laila I. Muderspach MD,

Laila I. Muderspach MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Heather A. Miller MD,

Heather A. Miller MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Ernesto Licon MD,

Ernesto Licon MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Crystal L. Adams MD,

Crystal L. Adams MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Laurie L. Brunette MD,

Laurie L. Brunette MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Huyen Q. Pham MD,

Huyen Q. Pham MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Annie A. Yessaian MD,

Annie A. Yessaian MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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Lynda D. Roman MD,

Lynda D. Roman MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA

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Koji Matsuo MD, PhD,

Corresponding Author

Koji Matsuo MD, PhD

[email protected]

orcid.org/0000-0002-6232-8701

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA

Email: [email protected]

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Marcia A. Ciccone MD,

Marcia A. Ciccone MD

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA

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First published: 27 April 2022

https://doi.org/10.1002/jso.26907

Citations: 1

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Abstract

Background and Objectives

Low anterior rectosigmoid resection for a gynecologic disease is usually performed in concert with other procedures and can result in significant morbidity should anastomotic complication occur. This study examined surgical outcomes of side-to-end reanastomosis after low anterior resection (STELAR) performed by gynecologic oncology service.

Methods

This is a case series examining consecutive patients who underwent STELAR for gynecologic indications by a single gynecologic oncology group from 2009 to 2018. Prospectively collected institutional surgical database was searched for STELAR, and standard descriptive statistics were used to describe intraoperative and postoperative complications specific to reanastomosis.

Results

A total of 69 women underwent STELAR, with median age and body mass index of 54 years and 24 kg/m², respectively. 63.8% of patients had ovarian cancer and 84.4% had stage III–IV disease. The median estimated blood loss was 875 ml. Four (5.8%) women underwent protective loop colostomy at the time of STELAR. Postoperatively, there was 1 (1.4%) case of abscess formation within 30 days and 1 (1.4%) case of anastomotic leak 5 weeks after STELAR that required reoperation and diversion. No cases of fistula were clinically identified.

Conclusion

Side-to-end reanastomosis may be a safe and feasible procedure to accomplish low rectosigmoid anastomosis in women with gynecologic disease.

CONFLICTS OF INTEREST

All were unrelated to the work: consultant, Quantgene (L.D.R.); none for others.

Open Research

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request, ethical review approval, and data use agreement.

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Citing Literature

Volume126, Issue3

September 1, 2022

Pages 563-570

Side-to-end reanastomosis after low-anterior resection (STELAR): Outcomes, feasibility, and description of procedure performed by a gynecologic oncology service

Abstract

Background and Objectives

Methods

Results

Conclusion

CONFLICTS OF INTEREST

Open Research

DATA AVAILABILITY STATEMENT

REFERENCES

Citing Literature

References

Information

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Side-to-end reanastomosis after low-anterior resection (STELAR): Outcomes, feasibility, and description of procedure performed by a gynecologic oncology service

Abstract

Background and Objectives

Methods

Results

Conclusion

CONFLICTS OF INTEREST

Open Research

DATA AVAILABILITY STATEMENT

REFERENCES

Citing Literature

References

Related

Information