Open abdominal vacuum pack technique for the management of severe abdominal complications after cytoreductive surgery in ovarian cancer.
Gynecol Oncol
; 170: 108-113, 2023 03.
Article
em En
| MEDLINE
| ID: mdl-36681011
ABSTRACT
INTRODUCTION:
The aim of this study was to evaluate the indications and management of grade III-IV postoperative complications in patients requiring vacuum-assisted open abdomen after debulking surgery for ovarian carcinomatosis.METHODS:
Retrospective study of prospectively collected data from patients who underwent a cytoreductive surgery by laparotomy for an epithelial ovarian cancer that required postoperative management of an open abdomen. An abdominal vacuum-assisted wound closure (VAWC) was applied in cases of abdominal compartmental syndrome (ACS) or intra-abdominal hypertension, to prevent ACS. The fascia was closed with a suture or a biologic mesh. The primary aim was to achieve primary fascial closure. Secondary outcomes considered included complications of cytoreductive surgery (CRS) and open abdominal wounds (hernia, fistula).RESULTS:
Two percent of patients who underwent CRS required VAWC during the study's patient inclusion period. VAWC indications included (i) seven cases of gastro-intestinal perforation, (ii) three necrotic enterocolitis, (iii) two intestinal ischemia, (iv) three anastomotic leakages and (v) four intra-abdominal hemorrhages. VAWC was used to treat indications (i) to (iv) (which represented 73.7% of cases), to prevent compartmental syndrome. Primary fascia closure was achieved in 100% of cases, in four cases (21.0%) a biologic mesh was used. Median hospital stay was 65 days (range 18-153). Four patients died during hospitalization, three of these within 30 days of VAWC completion.CONCLUSION:
VAWC for managing open abdominal wounds is a reliable technique to treat surgical post-CRS complications in advanced ovarian cancer and reduces the early post-operative mortality in cases presenting with severe complications.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Ovarianas
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Produtos Biológicos
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Tratamento de Ferimentos com Pressão Negativa
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Técnicas de Fechamento de Ferimentos Abdominais
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Traumatismos Abdominais
Tipo de estudo:
Etiology_studies
/
Observational_studies
Limite:
Female
/
Humans
Idioma:
En
Revista:
Gynecol Oncol
Ano de publicação:
2023
Tipo de documento:
Article