Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1-6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality ). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.

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Ovarian cancer becomes the most aggressive disease among all cancer pathology in women’s reproductive system. Surgery and chemotherapy are the main options on the way of ovarian cancer treatment. Cytoreductive surgeries are the main way of surgical treatment of patients with advanced ovarian cancer. The goal of this kind of surgeries is resections of all macroscopic implants.The opportunity of systematic lymph nodes dissection from renal vessels to obturator nerve is the reason of scientific discussion. LION trial (Lymphadenectomy In Ovarian Neoplasms) showed no significant difference in overall survival in two groups of patients with advanced ovarian cancer with IIВ–IV stages, who performed systematic lymphadenectomy and who did not. Authors showed higher level of postoperative complications in group with systematic lymph node dissections. But it was analyzed only those patients, who had intraoperative clinically insignificant lymph nodes. However, if the lymph nodes are macroscopically changed, performing a lymphadenectomy is advisable in order to achieve complete cytoreduction.Purpose of the study: assessment of lymph nodes dissection in patients with advanced ovarian cancer.Materials and methods. Retrospective analysis of patients with primary ovarian cancer IIIC–IV stages with clinically significant lymph nodes, which were subjected to interval or primary cytoreduction with systematic lymphodissection from the level of renal vessels to the obturator pit.Results. Complete and optimal cytoreduction was achieved in patients with systemic para-aortic and pelvic lymphodissection from the level of renal vessels to the obturator pit, which was not accompanied by postoperative complications and fatality.Conclusion. The study results demonstrates the possibility of safe systemic lymphodissection, which contributes to the achievement of complete or optimal cytoreduction, and improves the rates of disease-free survival.

Introduction. Endometrial cancer ranks the third place in prevalence among all cancers in Ukraine. The surgical treatment and subsequent adjuvant treatment is planned according to the patient's risk group. The choice of radiation therapy and the need to add chemotherapy determines the level of recurrence-free survival. Objective. The aim of the study was to analyze the database of treated patients in National Cancer Institute, with I stage endometrial cancer intermediate and high-intermediate group; determination of the most frequent choice of radiation treatment in accordance with the risk group of patients with a hysterectomy with salpingo-oophorectomy for further observation and evaluation of diseasefree survival. Materials and methods. Retrospective was analysed 245 patients with high and intermediate risk groups with stage I endometrial cancer. The exclusion criteria were: low-risk patients, stages II–IV and non-endometrioid histological variant. Results. According to the analysis, there were 122/245 (49.8 %) patients of high risk group, 123/245 (50.2 %) of intermediate risk group. High-risk patients underwent external beam therapy and brychytherapy, supplemented by chemotherapy in 5.8 % of cases (7 patients), brachytherapy with external beam therapy was performed in 58.2 % of cases (71 patients), brachytherapy – in 8.1 % of cases (10 patients), external beam therapy was performed in 27.9 % cases. Intermediate and high-intermediate risk patients were distributed as follows: brachytherapy was performed in 41.5 % of cases (51 patients), brachytherapy with external beam therapy – 54.5 % (67 patients), external beam therapy was performed in 5 patients. Conclusion. Brachytherapy is available for patients with intermediate risk endometrial cancer and external beam therapy with possible addition of brachytherapy is recommended for high-intermediate and high-risk groups, especially in patients with lymphatic vascular involvement. All patients are monitored for further assessment of recurrence-free survival. Key words: endometrial cancer, lymphadenectomy, external beam therapy, chemo- and radiotherapy.