title: Evaluation of urgent multivisceral resections due to complications resulting from an advanced ovarian cancer.
abstract: Unlike other solid tumors (i.e. pancreas, gallbladder, stomach), an ovarian cancer is responsive to a systemic treatment with platinum derivates in 80% of patients. This apparent chemosensitivity justifies a broader surgical approach. A cytoreductive, "tumor-debulking" surgery is defined as an attempt to remove in a maximum degree all visible and detect-able lesions. Despite treatment, the advancement of the disease very often leads to complications defined as "surgical" and life-threatening.
  
  
  
  The aim was to evaluate the efficacy and safety of palliative surgery in advanced ovarian cancer implicating acute surgical diseases of the abdominal cavity.
  
  
  
  Between years 2005 and 2014 were operated 118 patients with an advanced ovarian cancer (FIGO III-IV) implicating acute and directly life-threatening diseases of the abdominal cavity, involving 132 surgical operations. The causes of these operations were: obstruction of the gastrointestinal tract - 91 patients; perforation of the gastrointestinal tract - 15; gastrointestinal bleeding - 9; intussusceptions - 3.
  
  
  
  Retrospective data for the 118 patients were analyzed. Safety and the perioperative mortality rate were assessed. Serious postoperative complications were recorded in 31 patients (anastomotic stoma - 9; bleeding requiring repeated surgery -3; recurring gastrointestinal obstruction - 16; liver failure after partial hepatic resection - 3). Systemic compli-cations in the form of respiratory failure and cardiovascular disorders requiring cardiological treatment - 21. All patients required clinical nutrition, both parenteral and enteral. Deaths recorded - 3. 39 patients were rehospitalized within 30 days of surgery. 7 deaths were recorded in this group.
  
  
  
  Combining lifesaving surgery with cytoreduction allows further adjuvant treatment. Early rehospitalization occurring within less than 30 days is linked to increased mortality.
authors.affiliation: Chair and Department of General, Vascular and Oncologic Surgery, 2nd Faculty of Medicine, Warsaw Medical University, Poland. tomasz_milek@wp.pl.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Miłek
authors.forename: Witold
authors.initials: W
authors.lastname: Woźniak
authors.forename: Piotr
authors.initials: P
authors.lastname: Porzycki
authors.forename: Alkalayla
authors.initials: A
authors.lastname: Habib
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Timorek
authors.forename: Piotr
authors.initials: P
authors.lastname: Ciostek
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Sawicki
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Cendrowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D010052:Ovariectomy; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: multivisceral resections; ovarian cancer