Perioperative fluid status and surgical outcomes in patients undergoing cytoreductive surgery for advanced epithelial ovarian cancer
Section snippets
Background
The goal of cytoreductive surgery (CRS) in advanced ovarian cancer is complete surgical resection to no gross residual disease. Each incremental decrease in the volume of residual disease after CRS has been associated with progressively improved overall survival [1], [2]. To achieve this goal, multi-organ resections including extensive pelvic dissection, intestinal resection, and upper abdominal procedures are commonly required [3]. While radical CRS may be associated with morbidity and
Methods
After obtaining Institutional Review Board approval, all women who underwent surgery for ovarian, fallopian tube, or peritoneal cancer between 12/2010 and 05/2015 at the Johns Hopkins Hospital were identified using an institutional ovarian cancer registry database. All patients were operated on by experienced gynecologic oncologic surgeons trained in radical upper abdominal and pelvic cytoreductive surgical techniques. Standard antibiotic prophylaxis was administered within 30 min of skin
Results
In total, 110 women underwent surgery for stage III or IV ovarian, fallopian tube, or peritoneal cancer met inclusion criteria. Demographic information is detailed in Table 1. The median patient age was 62 years (range 31–88 years). The median BMI was 25.8 kg/m2 (range 16.6–47.9 kg/m2). The most common comorbidity observed was hypertension (43.6%). Performance status was not available for most patients and, therefore, not included. Stage distributions were as follows: 11 (10.0%) stage IIIA–B; 82
Discussion
Fluid overload refers to a constellation of clinical findings including edema, laboratory changes, pulmonary edema, need for diuretics and heart failure. Daily weight measurement in the post-operative setting has been utilized as an indicator of fluid status [8], [9], [10], [13], [14]. As volume of fluid administration is only one factor in the development of fluid overload, for the current study, perioperative weight increase was used as a comprehensive measure of fluid status. Our study
Conflicts of interest
The authors declare no conflicts of interest.
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