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Removal of malignant ovarian tumor with complications of colonic fistula

A patient with a malignant ovarian tumor complicated by a colonic fistula - an extremely dangerous condition, once considered "incurable" - had successful surgery to remove the tumor.

Báo Nhân dânBáo Nhân dân15/07/2025

Doctor advises patient.
Doctor advises patient.

Ms. LTĐ was admitted to Vinmec Central Park International General Hospital ( Ho Chi Minh City) with prolonged abdominal pain, fatigue and a weight loss of 7kg in just 3 months.

Through examination, the doctor discovered a 10-12cm abdominal tumor located in the left ovary and classified as having a high risk of malignancy (ORADS 5). Ultrasound images and clinical examination also showed that the tumor was firmly attached to the colon, with gas inside - an extremely rare sign in ovarian tumors, raising suspicion of a fistula.

Instead of intervening immediately, the doctors performed an MRI and colonoscopy to determine the exact situation. The results confirmed the initial concerns: there was a fistula between the colon and the ovarian tumor. If surgery were performed immediately, the risk of fecal leakage, peritonitis, and the need for an artificial anus was very high.

Given the patient's state of exhaustion, anemia, and malnutrition, the multidisciplinary team decided to postpone surgery to focus on improving his physical condition before surgery.

In the 7 days before surgery, the patient received comprehensive care from blood transfusion, iron supplementation and nutrition under close coordination between the departments of hematology, nutrition, ICU, anesthesia, gynecology, and gastroenterology.

When the patient's condition was stable, the Vinmec medical team performed a 6-hour major surgery with the coordination of specialist II Nguyen Chi Quang (Head of Obstetrics and Gynecology Department), specialist II Nguyen Van Nghia (Digestive Surgery), expert William A. Casteleins and the anesthesia and resuscitation team.

The tumor was firmly attached to the rectum, pelvic wall, and the entire sigmoid colon (a part of the large intestine). During the dissection, the doctors discovered a perforation in the colon as diagnosed. The team performed two major surgeries simultaneously, including hysterectomy, two adnexa, left colon, greater omentum resection, and pelvic and aortic lymph node dissection.

In particular, the doctor used an automatic intestinal stapler to help re-establish digestive circulation during surgery, helping the patient avoid temporary anal opening, shortening recovery time.

Specialist II Doctor Nguyen Chi Quang (Head of Obstetrics and Gynecology Department) said that if the surgery is divided into two sessions, the risk is very high. The most optimal solution is to combine and thoroughly handle the problem in one surgery.

After surgery, the patient was cared for in the intensive care unit, closely monitoring her nutritional status and rehabilitation. Thanks to effective coordination between multidisciplinary teams, Ms. D. recovered well, was mentally stable, and had regular check-ups after discharge.

"I am very grateful to the doctors at Vinmec. Not only are they good at their profession, they are also very dedicated and thoughtful. Now my health is almost back to normal," Ms. D. said emotionally.

The success of the complex surgery not only demonstrates outstanding professional capacity but also proves the effectiveness of the multidisciplinary treatment model at Vinmec - where every step from diagnosis to surgery is closely coordinated and comprehensively handled.

Source: https://nhandan.vn/loai-bo-khoi-u-buong-trung-ac-tinh-co-bien-chung-lo-do-dai-trang-post893771.html


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