title: Do critical care units play a role in the management of gynaecological oncology patients? The contribution of gynaecologic oncologist in running critical care units.
abstract: Routine post-operative care in high dependency unit (HDU), surgical intensive care unit (SICU) and intensive care unit (ICU) after high-risk gynaecological oncology surgical procedures may allow for greater recognition and correct management of post-operative complications, thereby reducing long-term morbidity and mortality. On the other hand, unnecessary admissions to these units lead to increased morbidity - nosocomial infections, increased length of hospital stay and higher hospital costs. Gynaecological oncology surgeons continue to look after their patient in the HDU/SICU and have the final role in decision-making on day-to-day basis, making it important to be well versed in critical care management and ensure the best care for their patients. Post-operative monitoring and the presence of comorbid illnesses are the most common reasons for admission to the HDU/SICU. Elderly and malnutritioned patients, as well as, bowel resection, blood loss or greater fluid resuscitation during the surgery have prolonged HDU/SICU stay. Patients with ovarian cancer have a worse survival outcome than the patients with other types of gynaecological cancer. Dependency care is a part of surgical management and it should be incorporated formally into gynaecologic oncology training programme.
authors.affiliation: 1st Department of Obstetrics and Gynecology, Gynecological Oncology Unit, "Alexandra" Hospital, University of Athens, Athens, Greece.
authors.forename: Miona
authors.initials: M
authors.lastname: Davidovic-Grigoraki
authors.affiliation: 1st Department of Obstetrics and Gynecology, Gynecological Oncology Unit, "Alexandra" Hospital, University of Athens, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Thomakos
authors.affiliation: 1st Department of Obstetrics and Gynecology, Gynecological Oncology Unit, "Alexandra" Hospital, University of Athens, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Haidopoulos
authors.affiliation: 1st Department of Obstetrics and Gynecology, Gynecological Oncology Unit, "Alexandra" Hospital, University of Athens, Athens, Greece.
authors.forename: Giorgos
authors.initials: G
authors.lastname: Vlahos
authors.affiliation: 1st Department of Obstetrics and Gynecology, Gynecological Oncology Unit, "Alexandra" Hospital, University of Athens, Athens, Greece.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Rodolakis
mesh_terms: D003422:Critical Care; D019468:Disease Management; D005260:Female; D005833:Genital Neoplasms, Female / Q000628:therapy*; D006176:Gynecology; D017721:Hospital Costs; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D010819:Physician's Role; D011182:Postoperative Care; D000071077:Surgical Oncology
keywords: admission; gynaecological oncology surgery; high dependency unit; intensive care unit; outcome