The Detrimental Impact of Diverting Ileostomy on Renal Function after Tumor Debulking Surgery for Advanced Ovarian Cancer.

OBJECTIVE:This study aimed to investigate the impact of ileostomy on both short- and long-term renal function in patients with advanced ovarian cancer. METHODS:This retrospective, multi-institutional study included patients diagnosed with stage II-IV ovarian cancer who underwent primary or interval debulking surgery with rectal resection at five institutions in Japan between April 2013 and March 2022. We assessed renal function during and up to 12 months following postoperative adjuvant chemotherapy (AC), using estimated glomerular filtration rate (eGFR) values and the incidence of chronic kidney disease (CKD) in patients with or without ileostomy. RESULTS:A total of 215 patients were included in the study, of whom 87 patients (40.5 %) underwent ileostomy. When comparing patients with and without ileostomy, those with ileostomy had a lower eGFR from the first cycle of chemotherapy up to 12 months after AC (p < 0.0001). Additionally, patients who underwent ileostomy were more likely to develop CKD 12 months after AC (p < 0.0001). Logistic regression analysis identified age (p = 0.039), baseline renal dysfunction (p = 0.013), and ileostomy (p < 0.001) as independent risk factors for CKD at 12 months after AC. Furthermore, stoma closure did not result in an improvement in eGFR. In patients who underwent ileostomy, high stoma output (>1500 mL/day) was independently associated with CKD development at 12 months after AC. CONCLUSIONS:In patients with ovarian cancer, ileostomy can impair renal function following AC, and this effect persists even after stoma closure.