Different patterns of postoperative bleeding following cytoreductive surgery for gynecological cancer.
OBJECTIVE
To study the possible causes of postoperative bleeding following maximal cytoreductive surgery for gynecological cancers.


METHODS
We have retrospectively reviewed all our cases of postoperative bleeding following major abdominal and pelvic cytoreductive surgery within a 48-hour period. In the postoperative period, replacement therapy was ineffective in achieving hemodynamic stability. During re-operation, the entire abdominal cavity was evaluated for bleeding sites that were adequately ligated or electrocoagulated.


RESULTS
Of 942 women undergoing major cytoreductive surgery 22 women (2.3%) were re-operated for postoperative bleeding after a mean of 14.2 hours. Bleeding was either localized from a vessel in 9 women (40.9%) or diffuse (capillary oozing) in 13 women (59.1). Operative deaths have been as high as 36.8%.


CONCLUSIONS
Postoperative bleeding following cytoreductive surgery can be from a single group of vessels or a capillary oozing from the edges or denuded areas of excised peritoneum.
Campagnutta
E
E
Gynecological Oncology Department, Oncology Referral Center, Aviano, Pordenone, Italy.
Giorda
G
G
De Piero
G
G
Gallo
A
A
Fantin
D
D
Scarabelli
C
C
D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D009026:Mortality; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology