Anaesthetic issues in women undergoing gynaecological cytoreductive surgery.
OBJECTIVE
Increasing numbers of women with ovarian cancer are undergoing cytoreductive surgery in reference centres. This review looks at this disease in these women and the different aspects of perioperative clinical management of these patients by the anaesthetic team: preoperative screening, anaesthetic techniques, fluid or blood management or both and prevention and treatment of important complications.


RESULTS
The outcome for women with ovarian cancer can be influenced not only by the timing of surgery or chemotherapy or both but also by anaesthetic technique, especially by combining general anaesthesia and central neural blockade, by a rational approach to perioperative fluid management and by administration of statins.


CONCLUSIONS
Anaesthesia is more than 'keeping asleep'. Anaesthesiologists have an enormous responsibility in the preoperative, peroperative, and postoperative period for patients undergoing gynaecological cytoreductive surgery.
Vanacker
Bernard
B
Department of Anaesthesia, University Hospitals KULeuven, U.Z. Gasthuisberg, Herestraat 49, Leuven B 3000, Belgium. bernard.vanacker@uz.kuleuven.ac.be