The value of ureteric stents in debulking surgery for disseminated ovarian cancer.

OBJECTIVES

To review the value of ureteric catheterization in extensive debulking surgery in women with disseminated ovarian cancer.

METHODS

Our database was searched for all women who had a laparotomy for advanced stage (stages III and IV) ovarian cancer between January 2001 and December 2007. Women who had the word(s) "ureteric," "ureter," "stent," "stents," and "stented" either in their operation notes or the multidisciplinary meeting discussions were filtered to identify those who had a ureteric stent inserted. Stents inserted because of excision/injury to ureters with reanastomosis or reinsertion to bladder were excluded.

RESULTS

Fourteen out of 442 patients were identified as having a "prophylactic" stent inserted. The mean age of this series of 14 women was 66.6 years. Seven women had ultraradical surgery requiring bowel resection and/or resection of tumor from the bladder. Nine women had a stent inserted because of the presence of a hydroureter, 3 for ureteric stricture and 2 to protect a flimsy or fragile ureter after ureteric dissection and tumor debulking. There were no ureteric complications during the post-operative period. This resulted in 9 (64%) women achieving either complete or optimal cytoreduction of their tumor bulk. Optimal/complete cytoreduction in all stage III/IV cases during this period was 88%.

CONCLUSIONS

Ureteric silastic stents are relatively easy to insert and pose few immediate and long-term problems. They should be considered in women after extensive pelvic side-wall debulking in an attempt to reduce the risk of postoperative ureteric complications.