Multivisceral pelvic resections for ovarian cancer: short-term results

Aim. To evaluate whether blood preservation and a perioperative clinical pathway might reduce the rate of complications after multivisceral pelvic resections in patients with advanced ovarian cancer.Materials and methods: From 2018 to 2024 we performed 50 multivisceral pelvic resections in patients with advanced ovarian cancer. Age was 57,4±12,9 years, BMI - 27,9±6,4 kg/m2 . We previously developed and implemented a standardized protocol for blood preservation and perioperative management of patients in order to reduce the number of complications after multivisceral pelvic resections. The protocol included meticulous tissue preparation under magnification and en bloc visceral resections instead of gut wall “shaving” apart of anaesthesiological components. The severity of complications was assessed according to Dindo-Clavien classification.Results: Duration of operations was 305±99 min, blood loss constituted 242±221 ml, postoperative mortality - 0. Grade II-IVa complications developed in 42 % of cases, surgical site infection - 20 %. Median hospital stay after surgery was 10,5±9,4 days. The only factor that had a significant impact on the incidence of severe complications was the complexity of the operation according to Aletti (odds ratio 7,364, 95 % CI: 1,671 - 32,440, p = 0,007). The volume of intraoperative blood loss ≥ 250 ml remained the only predictor of infectious complications in multivariate analysis.Conclusion. The use of a standardized perioperative clinical pathway in patients with advanced ovarian cancer allowed us to achieve an acceptable rate of severe postoperative complications after extensive pelvic resections.