En-bloc pelvic resection with concomitant rectosigmoid colectomy and immediate anastomosis as part of primary cytoreductive surgery for patients with advanced ovarian cancer.

OBJECTIVE: To assess the authors' experiences in en bloc pelvic resection with concomitant rectosigmoid colectomy and primary anastomosis as a part of primary cytoreductive surgery for patients with advanced ovarian cancer. MATERIALS AND METHODS: Atotal of 22 patients with FIGO Stage IIB-IV epithelial ovarian cancer who underwent en bloc pelvic resection with anastomosis were retrospectively reviewed. Data analyses were carried out using SPSS 10.0 and descriptive statistics, Kaplan-Meier survival curves, and Log Rank (Mantel-Cox) test were used for statistical estimations. RESULTS: Median age was 58.8 years. FIGO stage distribution of the patients was; one (4.5%) IIB, three (13.7%) IIC, three (13.7%) IIIA, six (27.3%) IIIB, and nine (40.9%) IIIC. Median peritoneal cancer index (PCI) was 8 (range 5-22) and optimal cytoreduction was achieved in 18 patients (81.8%) of whom 13 (59.1%) had no macroscopic residual disease (complete cytoreduction). There was no perioperative mortality. A total of nine complications occurred in seven (31.8%) patients. Anastomotic leakage was observed in one (4.5%) patient. There was no re-laparotomy. Mean follow-up time was 60 months. There were 15 (68.2%) recurrences of which 12 (80%) presented in extra-pelvic localizations. Mean disease-free survival (DFS) and overall survival (OVS) were estimated as 43.6 and 50.5 months, respectively. Patients with complete cytoreduction had a better DFS (p = 0.006) and OVS (p = 0.003) than those with incomplete cytoreduction. CONCLUSION: En bloc pelvic resection, as a part of surgical cytoreduction, seems to be a safe and effective procedure in many patients with advanced ovarian cancer if required. Despite relatively high general complication rate, anastomosis-related morbidity of this procedure is low as 0.8%. Nevertheless, surgical plan and perioperative care should be personalized according to medical and surgical conditions of the patient.

The effect of methylphenidate on overactivity in rats prenatally exposed to alcohol.

Pregnant Long-Evans rats were provided with isocaloric liquid diets containing either ethanol or sucrose, or a standard lab chow diet. Male offspring were utilized to test the effectiveness of methylphenidate in mitigating the overactivity associated with prenatal alcohol exposure. In two experiments, 19 day old rat pups from each prenatal condition were injected with methylphenidate and placed in an open-field. Subjects in the first experiment were injected with 0, 0.5 or 1.0 mg/kg methylphenidate and tested for 5 minutes on each of 3 consecutive days. Drug doses in the second experiment were 0, 2.0 or 8.6 mg/kg and subjects were tested over four days. No evidence was obtained in either experiment that methylphenidate reduced the overactivity of the alcohol-exposed offspring. In fact, in the second experiment, pups exposed to alcohol in utero appeared more sensitive to the stimulating effects of methylphenidate than controls.