Evidence map›Paper›PMID 39379788›Full record

ArticleAnnals of surgical oncology2024

Intraoperative Fluid Balance and Perioperative Complications in Ovarian Cancer Surgery.

Eva K Egger, Janina Ullmann, Tobias Hilbert, Damian J Ralser, Laura Tascon Padron, Milka Marinova, Matthias Stope, Alexander Mustea

Abstract read
In one paragraph

Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Eva K EggerDepartment of Gynecology and Gynecological Oncology, University Hospital, Bonn, Germany. eva-katharina.egger@ukbonn.de.ORCID http://orcid.org/0000-0002-9891-3996
Janina UllmannDepartment of Gynecology and Gynecological Oncology, University Hospital, Bonn, Germany.
Tobias HilbertDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
Damian J RalserDepartment of Gynecology and Gynecological Oncology, University Hospital, Bonn, Germany.
Laura Tascon PadronDepartment of Gynecology and Gynecological Oncology, University Hospital, Bonn, Germany.
Milka MarinovaDepartment of Nuclear Medicine, University Hospital, Bonn, Germany.
Matthias StopeDepartment of Gynecology and Gynecological Oncology, University Hospital, Bonn, Germany.
Alexander MusteaDepartment of Gynecology and Gynecological Oncology, University Hospital, Bonn, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFluid overload and hypovolemia promote postoperative complications in patients undergoing cytoreductive surgery for ovarian cancer. In the present study, postoperative complications and anastomotic leakage were investigated before and after implementation of pulse pressure variation-guided fluid management (PPVGFM) during ovarian cancer surgery. PATIENTS AND

methodsA total of n = 243 patients with ovarian cancer undergoing cytoreductive surgery at the University Hospital Bonn were retrospectively evaluated. Cohort A (CA; n = 185 patients) was treated before and cohort B (CB; n = 58 patients) after implementation of PPVGFM. Both cohorts were compared regarding postoperative complications.

resultsUltrasevere complications (G4/G5) were exclusively present in CA (p = 0.0025). No difference between cohorts was observed regarding severe complications (G3-G5) (p = 0.062). Median positive fluid excess was lower in CB (p = 0.001). This was independent of tumor load [peritoneal cancer index] (p = 0.001) and FIGO stage (p = 0.001). Time to first postoperative defecation was shorter in CB (CB: d2 median versus CA: d3 median; p = 0.001). CB had a shorter length of hospital stay (p = 0.003), less requirement of intensive medical care (p = 0.001) and postoperative ventilation (p = 0.001). CB received higher doses of noradrenalin (p = 0.001). In the combined study cohort, there were more severe complications (G3-G5) in the case of a PFE ≥ 3000 ml (p = 0.034) and significantly more anastomotic leakage in the case of a PFE ≥ 4000 ml (p = 0.006).

conclusionsIntraoperative fluid reduction in ovarian cancer surgery according to a PPVGFM is safe and significantly reduces ultrasevere postoperative complications. PFEs of ≥ 3000 ml and ≥ 4000 ml were identified as cutoffs for significantly more severe complications and anastomotic leakage, respectively.

Indexed as

Cytoreduction Surgical ProceduresFluid TherapyOvarian NeoplasmsPostoperative ComplicationsWater-Electrolyte BalanceAdultAgedAged, 80 and overAnastomotic LeakFemaleFollow-Up StudiesHumansIntraoperative ComplicationsLength of StayMiddle AgedPrognosisAnastomotic leakageComplicationsFluid overloadFluid restrictionOvarian cancer

Identifiers

PMID39379788
PMCPMC11549190

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.