TY - JOUR
T1 - Predictors of postoperative morbidity after cytoreduction for advanced ovarian cancer: Analysis and management of complications in upper abdominal surgery
AU - Benedetti Panici, Pierluigi
AU - Di Donato, Violante
AU - Fischetti, Margherita
AU - Casorelli, Assunta
AU - Perniola, Giorgia
AU - Musella, Angela
AU - Marchetti, Claudia
AU - Palaia, Innocenza
AU - Berloco, Pasquale
AU - Muzii, Ludovico
PY - 2015
Y1 - 2015
N2 - Objective To evaluate the complication rate and its impact in patients who have undergone upper abdominal surgery for treatment of advanced ovarian cancer. Methods Patients who have undergone upper abdominal surgery including diaphragm surgery, splenectomy, distal pancreatectomy, gastric resection, liver resection and biliary surgery were considered for the study. Perioperative complications were evaluated and graded according to Clavien-Dindo. Results One hundred and twenty one patients were included. Two hundred and twelve surgical procedures were performed. Thirty-six patients reported at least one complication, but 61.1% of these the complication was mild. Median hospital stay for patients with and without complication was 7 vs. 13 days respectively (p < 0.001). There was a significant correlation between post-operative hospital stay and the total number of surgical procedures (R = 0.445, p < 0.001). At multivariate analysis, diaphragmatic resection and pancreatic resection were associated with a significant increase of postoperative hospital stay, furthermore diaphragmatic resection (p = 0.004), hepatic resection (p = 0.004), pancreatectomy (p = 0.011) and biliary surgery (p = 0.049) were independent predictors of severe (G3-G4) complication. Conclusions Rate of complications of patients submitted to upper abdominal surgery for ovarian cancer is acceptable. Prediction of severe complications is the goal for its optimal management. Extensive procedures should be avoided with those patients in which optimal residual tumor could not be reached.
AB - Objective To evaluate the complication rate and its impact in patients who have undergone upper abdominal surgery for treatment of advanced ovarian cancer. Methods Patients who have undergone upper abdominal surgery including diaphragm surgery, splenectomy, distal pancreatectomy, gastric resection, liver resection and biliary surgery were considered for the study. Perioperative complications were evaluated and graded according to Clavien-Dindo. Results One hundred and twenty one patients were included. Two hundred and twelve surgical procedures were performed. Thirty-six patients reported at least one complication, but 61.1% of these the complication was mild. Median hospital stay for patients with and without complication was 7 vs. 13 days respectively (p < 0.001). There was a significant correlation between post-operative hospital stay and the total number of surgical procedures (R = 0.445, p < 0.001). At multivariate analysis, diaphragmatic resection and pancreatic resection were associated with a significant increase of postoperative hospital stay, furthermore diaphragmatic resection (p = 0.004), hepatic resection (p = 0.004), pancreatectomy (p = 0.011) and biliary surgery (p = 0.049) were independent predictors of severe (G3-G4) complication. Conclusions Rate of complications of patients submitted to upper abdominal surgery for ovarian cancer is acceptable. Prediction of severe complications is the goal for its optimal management. Extensive procedures should be avoided with those patients in which optimal residual tumor could not be reached.
KW - Advanced ovarian cancer
KW - Complication rate
KW - Predictors of complication rate
KW - Predictors of postoperative morbidity
KW - Upper abdominal surgery
KW - Advanced ovarian cancer
KW - Complication rate
KW - Predictors of complication rate
KW - Predictors of postoperative morbidity
KW - Upper abdominal surgery
UR - http://hdl.handle.net/10807/203897
U2 - 10.1016/j.ygyno.2015.03.043
DO - 10.1016/j.ygyno.2015.03.043
M3 - Article
SN - 0090-8258
VL - 137
SP - 406
EP - 411
JO - Gynecologic Oncology
JF - Gynecologic Oncology
ER -