Exenteración pélvica para neoplasias ginecológicas: Complicaciones postoperatorias y resultados oncológicos

Romeo, Agustín; González, Matías Ignacio; Jaunarena, Jorge; Zubieta, Maria Ercilia; Favre, G.; Tejerizo, Juan Carlos

doi:10.1016/j.acuro.2017.05.004

Cited by 13 publications

(2 citation statements)

References 10 publications

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“…Complete cytoreduction is one of the main prognostic factors for patients with ovarian cancer [1][2][3]. To achieve complete macroscopic tumor resection, extensive multi-visceral procedures are performed [4]. Severe complications can be the result of complex procedures.…”

Section: Introductionmentioning

confidence: 99%

“…Severe complications can be the result of complex procedures. These complications can result in prolonged recovery periods and delays in the initiation of adjuvant therapy with consequent worsened overall outcome [4,5]. When alternate strategies such as neoadjuvant chemotherapy are discussed, the individual evaluation of patients is crucial [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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ECOG and BMI as preoperative risk factors for severe postoperative complications in ovarian cancer patients: results of a prospective study (RISC-GYN—trial)

Inci

Rasch

Woopen

et al. 2021

Arch Gynecol Obstet

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Background Accompanying co-morbidities in patients with ovarian cancer are of major relevance for scheduling debulking surgery, especially in the anesthesiological consultations. Aim of this study was to evaluate the impact of co-morbidities and patient characteristics on postoperative complications. Methods Patients undergoing maximal cytoreductive surgery were prospectively enrolled from October 2015 to January 2017. Various variables were recorded, such as the Charlson comorbidity index, Eastern cooperative oncology group scale of performance status (ECOG PS) and the American society of anesthesiologists physical status classification system (ASA PS). Surgical complications were graded using the Clavien–Dindo criteria. Logistic regression models were used to analyze risk factors for severe postoperative complications. Results Of 106 enrolled patients, 19 (17.9%) developed severe postoperative complications grade ≥ IIIb according to Clavien–Dindo criteria. In the multivariable regression analysis impaired (ECOG PS) > 1 (odds ratio OR) 13.34, 95% confidence interval (CI) 1.74–102.30, p = 0.01), body mass index (BMI) > 25 kg/m2 (OR 10.48, 95% CI 2.38–46.02, p = 0.002) along with the use of intraoperative norepinephrine > 0.11 µg/kg/min (OR 4.69, 95% CI 1.13–19.46, p = 0.03) and intraoperative fresh frozen plasma (FFP) > 17 units (OR 4.11, 95% CI 1.12–15.14, p = 0.03) appeared as significant predictors of severe postoperative complications. Conclusion We demonstrated that neither the presence of a certain comorbidity nor the summation of the co-morbidities were associated with adverse outcome. Patient characteristics, such as ECOG PS > 1 and obesity (BMI > 25 kg/m2), are highly predictive factors for severe postoperative complications. The analysis of intraoperative data showed that the need for more than > 0.11 µg/kg/min of norepinephrine and transfusions of FFPs more than 17 units were strongly associated with severe postoperative complications.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

ECOG and BMI as preoperative risk factors for severe postoperative complications in ovarian cancer patients: results of a prospective study (RISC-GYN—trial)

Inci

Rasch

Woopen

et al. 2021

Arch Gynecol Obstet

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Effects of sarcopenia and malnutrition on morbidity and mortality in gynecologic cancer surgery: results of a prospective study

Sehouli

Mueller

Richter

et al. 2021

J cachexia sarcopenia muscle

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Background Malnutrition and sarcopenia often occur simultaneously in cancer patients and are thought to have harmful effects on both surgical and oncological outcomes. Therefore, we want to evaluate the effects of sarcopenia and malnutrition on severe postoperative complications and overall survival in gynecologic cancer patients. Methods We assessed nutritional parameters and run a bioelectrical impedance analysis in 226 women. Extracellular mass to body cell mass index, phase angle alpha, muscle mass, and fat mass were evaluated. To determine if patients suffer from sarcopenia, we ran the Timed 'Up and Go' test, performed hand grip strength, and calculated a skeletal muscle index. Postoperative complications were categorized using Clavien-Dindo Classification. Utilizing ROC analysis and logistic regression, we determined predictive clinical factors for severe postoperative complications. Kaplan-Meier method and log-rank test were used for overall survival analysis. Results Of the 226 female patients, 120 (53%) had a BMI ≥ 25 kg/m 2 , 56 (26%) had a phase angle < 4.75°, and 68 (32%) were sarcopenic according to skeletal muscle index < 27%. Within 30 days after surgery, 40 (18%) patients developed severe postoperative complications, and 4% had died. According to multivariable regression analysis, ECOG status

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Empty Pelvis Syndrome Complication Management Following Pelvic Exenteration

Quinn,

Steele

2024

Coloproctology

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Exenteración pélvica para neoplasias ginecológicas: Complicaciones postoperatorias y resultados oncológicos

Cited by 13 publications

References 10 publications

ECOG and BMI as preoperative risk factors for severe postoperative complications in ovarian cancer patients: results of a prospective study (RISC-GYN—trial)

ECOG and BMI as preoperative risk factors for severe postoperative complications in ovarian cancer patients: results of a prospective study (RISC-GYN—trial)

Effects of sarcopenia and malnutrition on morbidity and mortality in gynecologic cancer surgery: results of a prospective study

Empty Pelvis Syndrome Complication Management Following Pelvic Exenteration

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