The perioperative management of patients with gynaecological cancer undergoing major surgery: A debated clinical challenge

Gadducci, Angiolo; Cosio, Stefania; Spirito, Nicoletta; Genazzani, Andrea Riccardo

doi:10.1016/j.critrevonc.2009.02.008

Cited by 29 publications

(22 citation statements)

References 134 publications

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“…In support of our results, it has been reported that ovarian cancer is associated with the same high risk of VTE as pancreatic cancer and brain cancer [16]. Tateo et al reported that ovarian cancer was associated with the highest risk of VTE among gynecologic diseases [17].…”

Section: Resultssupporting

confidence: 90%

Risk factors for perioperative venous thromboembolism: A retrospective study in Japanese women with gynecologic diseases

et al. 2010

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BackgroundPatients with gynecologic cancer have a high risk of venous thromboembolism (VTE) like patients with other cancers. However, there is little information on risk factors for VTE during gynecologic surgery and no uniform preventive strategy. Our objectives were to identify risk factors for perioperative VTE in gynecologic patients and establish methods for prevention.MethodsWe analyzed 1,232 patients who underwent surgery at the Department of Obstetrics and Gynecology of St. Marianna University School of Medicine between January 2005 and June 2008. We investigated (1) risk factors for preoperative VTE, (2) use of an inferior vena cava (IVC) filter, and (3) risk factors for postoperative VTE.ResultsThere were 39 confirmed cases of perioperative VTE (3.17%), including 25 patients with preoperative VTE and 14 with postoperative VTE. Thirty-two patients had cancer and seven patients had benign diseases. Twenty-two of the 32 cancer patients (68.7%) had preoperative VTE, while postoperative VTE occurred in 10 cancer patients. Multivariate analysis indicated that ovarian cancer, tumor diameter ≥10 cm, and previous of VTE were independent risk factors for preoperative VTE. Among ovarian cancer patients, multivariate analysis showed that an age ≥50 years, the presence of heart disease, clear cell adenocarcinoma, and tumor diameter ≥20 cm were independent risk factors for preoperative VTE. The factors significantly related to preoperative VTE in patients with benign disease included previous VTE, age ≥55 years, tumor diameter ≥20 cm, and a history of allergic-immunologic disease. Thirteen of the 25 patients (52%) with preoperative VTE had an IVC filter inserted preoperatively. Postoperative screening (interview and D-dimer measurement) revealed VTE in 14/1,232 patients (1.14%). Multivariate analysis indicated that cancer surgery, a history of allergic-immunologic disease, and blood transfusion ≥2,000 ml were independent risk factors for postoperative VTE.ConclusionsPerioperative VTE is often fatal and preventive measures should be taken in the gynecologic field, especially when patients have the risk factors identified in this study. Since VTE is often present before surgery, preoperative screening is important and use of an IVC filter should be considered.

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Section: Resultssupporting

confidence: 90%

Risk factors for perioperative venous thromboembolism: A retrospective study in Japanese women with gynecologic diseases

et al. 2010

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“…Despite a paucity of literature specific to gynecologic surgery, it is reasonable to extrapolate from the general surgery data a recommendation against mechanical bowel preparation for the indication of decreasing infectious complications related to bowel injury or resection. 21 Antibiotic bowel preparation, however, has been proven beneficial in colorectal surgery and can reasonably be used in complicated gynecologic cases at high risk for bowel involvement. A caveat to this recommendation is the importance of understanding the clinical practices of consulting colorectal surgeons at individual institutions.…”

Section: Summary and Recommendationmentioning

confidence: 99%

The Role of Mechanical Bowel Preparation in Gynecologic Laparoscopy

Maseloane¹

2011

WJOLS

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Various combinations of dietary restriction, antibiotic regimens and mechanical preparations have become routine in preoperative surgical planning for elective colon surgery. This practice has also become commonplace in the field of gynecology, either for planned bowel surgery or in complex cases that are believed to be high risk for inadvertent bowel injury. As the trend in gynecologic surgery shifts toward more minimally invasive approaches, the complexity of cases being performed by laparoscopy and robotics continues to increase. In addition, laparoscopic surgical techniques have a different set of inherent risks and challenges as compared with open pelvic operations. This review summarizes the available data surrounding the use of mechanical bowel preparations, specifically with regard to gynecologic laparoscopy.

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“…Antibiotic regimen can be selected according to the types of surgery or surgeon’s preference. Additional use of prophylactic antibiotics is recommended to maintain effective levels of intravascular antibiotics in certain clinical situations, like massive bleeding or prolonged operative time [2324]. …”

Section: Perioperative Preparationmentioning

confidence: 99%

Surgical manual of the Korean Gynecologic Oncology Group: ovarian, tubal, and peritoneal cancers

et al. 2017

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The Surgery Treatment Modality Committee of the Korean Gynecologic Oncology Group has determined to develop a surgical manual to facilitate clinical trials and to improve communication between investigators by standardizing and precisely describing operating procedures. The literature on anatomic terminology, identification of surgical components, and surgical techniques were reviewed and discussed in depth to develop a surgical manual for gynecologic oncology. The surgical procedures provided here represent the minimum requirements for participating in a clinical trial. These procedures should be described in the operation record form, and the pathologic findings obtained from the procedures should be recorded in the pathologic report form. Here, we describe surgical procedure for ovarian, fallopian tubal, and peritoneal cancers.

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The perioperative management of patients with gynaecological cancer undergoing major surgery: A debated clinical challenge

Cited by 29 publications

References 134 publications

Risk factors for perioperative venous thromboembolism: A retrospective study in Japanese women with gynecologic diseases

Risk factors for perioperative venous thromboembolism: A retrospective study in Japanese women with gynecologic diseases

The Role of Mechanical Bowel Preparation in Gynecologic Laparoscopy

Surgical manual of the Korean Gynecologic Oncology Group: ovarian, tubal, and peritoneal cancers

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