Multivisceral pelvic resections for ovarian cancer: short-term results
https://doi.org/10.17238/2072-3180-2024-4-106-115
Abstract
Aim. To evaluate whether blood preservation and a perioperative clinical pathway might reduce the rate of complications after multivisceral pelvic resections in patients with advanced ovarian cancer.
Materials and methods: From 2018 to 2024 we performed 50 multivisceral pelvic resections in patients with advanced ovarian cancer. Age was 57,4±12,9 years, BMI – 27,9±6,4 kg/m2 . We previously developed and implemented a standardized protocol for blood preservation and perioperative management of patients in order to reduce the number of complications after multivisceral pelvic resections. The protocol included meticulous tissue preparation under magnification and en bloc visceral resections instead of gut wall “shaving” apart of anaesthesiological components. The severity of complications was assessed according to Dindo-Clavien classification.
Results: Duration of operations was 305±99 min, blood loss constituted 242±221 ml, postoperative mortality – 0. Grade II–IVa complications developed in 42 % of cases, surgical site infection – 20 %. Median hospital stay after surgery was 10,5±9,4 days. The only factor that had a significant impact on the incidence of severe complications was the complexity of the operation according to Aletti (odds ratio 7,364, 95 % CI: 1,671 – 32,440, p = 0,007). The volume of intraoperative blood loss ≥ 250 ml remained the only predictor of infectious complications in multivariate analysis.
Conclusion. The use of a standardized perioperative clinical pathway in patients with advanced ovarian cancer allowed us to achieve an acceptable rate of severe postoperative complications after extensive pelvic resections.
About the Authors
V. K. Lyadov
Moscow State Budgetary Healthcare Institution «Moscow City Hospital named S.S. Yudina, Moscow Healthcare Department»;
Russian Medical Academy of Continuous Professional Education;
Novokuznetsk State Medical Institute for Advanced Training of Physicians
Russian Federation
Russian Federation
Lyadov Vladimir Konstantinovich – PhD, Head of Division of Oncology № 4, Moscow, 115446;
Associate Professor at the Chair of Oncology and Palliative Medicine named after Academician I.A. Savitsky, Moscow;
Head of the Chair of Oncology, Novokuznetsk
A. N. Moskalenko
Moscow State Budgetary Healthcare Institution «Moscow City Hospital named S.S. Yudina, Moscow Healthcare Department»
Russian Federation
Russian Federation
Moskalenko Aleksei Nikolaevich – Oncologist of Division of Oncology № 4,
115446, Moscow, 117152, Zagorodnoe road, 18A
M. R. Garipov
Moscow State Budgetary Healthcare Institution «Moscow City Hospital named S.S. Yudina, Moscow Healthcare Department»
Russian Federation
Russian Federation
Garipov Marat Ruslanovich – Oncologist of Division of Oncology № 4,
115446, Moscow, 117152, Zagorodnoe road, 18A
A. S. Nevrov
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Nevrov Andrey Sergeevich – resident, Department of Oncology and Palliative Medicine named after Academician I.A. Savitsky,
125993, Moscow, Barrikadnaya st., 2/1, bldg 1
D. S. Fedorinov
Moscow State Budgetary Healthcare Institution «Moscow City Hospital named S.S. Yudina, Moscow Healthcare Department»;
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Fedorinov Denis Sergeevich – Oncologist of Division of Chemotherapy,
117152, Moscow, Zagorodnoe road, 18A
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For citations:
Lyadov V.K., Moskalenko A.N., Garipov M.R., Nevrov A.S., Fedorinov D.S. Multivisceral pelvic resections for ovarian cancer: short-term results. Moscow Surgical Journal. 2024;(4):106-115. (In Russ.) https://doi.org/10.17238/2072-3180-2024-4-106-115
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