Critical care issues in cervical cancer management

Abstract

Radical pelvic surgery in gynecologic oncology patients poses a challenge to the surgeon and the ancillary team in charge of the peri‐operative care. The high frequency of medical problems observed in this patient population, in conjunction with the stresses of radical surgery, necessitates careful monitoring of patients' medical status. A comprehensive team approach in the peri‐operative period is critical to patient care. Early intervention and anticipation of potential problems for the patient at risk in the postoperative period minimizes morbidity and mortality. This article will review the essentials of critical care as it relates to patients undergoing radical pelvic operations. Semin. Surg. Oncol. 16:267–274, 1999. © 1999 Wiley‐Liss, Inc.

Outcomes of gynecologic oncology patients admitted to the intensive care unit following surgery: a university teaching hospital experience

“…Operative blood loss during radical hysterectomy is the primary reason for ICU admission in cervical cancer patients (12) . Importantly, the majority of hemodynamic issues were successfully managed without pulmonary artery catheters alleviating the need for an additional invasive procedure and the associated risks.…”

Postoperative Admission in Critical Care Units Following Gynecologic Oncology Surgery: Outcomes Based on a Systematic Review and Authors' Recommendations

“…For patients with advanced stage tumors that are considered resectable, extensive cytoreductive procedures are required with the intention to achieve complete cytoreduction (1). Elevated rates of perioperative morbidity and mortality have been reported in these patients and have been mainly associated with either the patients' past medical history and performance status or the type of surgery and the underlying malignant disease or with a combination of those factors (2,3). Therefore, critical care management is critical for surgically managed patients with the intent to establish a closer monitoring and to prevent or treat postoperative complications (4).…”

“…Routine postoperative admission to the ICU has been used by several institutions especially in cases of debulking surgery for advanced ovarian cancer or radical exenteration procedures for cervical cancer which require prolonged and complex surgical procedures (2). A number of studies have focused on the cost-effectiveness of utilizing CCUs as a routine after major surgeries while simultaneously attempt to designate the selection criteria for patients who require admission to CCU and evaluate the pre-and perioperative factors that predispose to admission to CCUs (6,7).…”