Morbidity and mortality of stapled anastomoses on a gynecologic oncology service: a retrospective review.

The Gynecologic Oncology Division performed 167 operations requiring intestinal resection during the period July 1, 1980 to May 30, 1989. Stapling instruments were utilized in 155 procedures and resulted in 204 anastomoses. Major morbidity occurred in 36 (23%) patients, including 17 (11%) deaths and (4.5%) fistulas. Minor morbidity, such as ileus and atelectasis, occurred in 46 (30%) patients. Intestinal surgery is required in approximately 10% of gynecologic oncology procedures, and is associated with significant major and minor morbidity, particularly in obstructed patients.