RESUMEN
BACKGROUND: This study was undertaken to evaluate the use of the ultrasound surgical aspirator in ovarian cancer and to determine if cytoreduction was improved with its use. METHODS: The study is a retrospective case control trial. Twenty-six consecutive ovarian cancer patients who had the ultrasound surgical aspirator used during their surgery were retrospectively compared to 25 consecutive ovarian cancer patients who did not have the ultrasound surgical aspirator used during their surgeries. The latter group had their surgeries immediately before the ultrasound surgical aspirator was introduced into the hospital. Both groups were similar in age, stage, histology type, grade, and median number of chemotherapy cycles. RESULTS: Patients that had the ultrasound surgical aspirator used had a 69% optimal cytoreduction rate compared to 16% in the control group (p = .001). This was statistically significant (p = 0.001). Survival time was equal in both groups. CONCLUSIONS: Results of the study showed that use of the ultrasound surgical aspirator may permit more patients to be optimally cytoreduced.
Asunto(s)
Neoplasias Ováricas/cirugía , Ultrasonografía Intervencional/métodos , Estudios de Casos y Controles , Femenino , Humanos , Persona de Mediana Edad , Neoplasias Ováricas/diagnóstico por imagen , Neoplasias Ováricas/patología , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Succión/métodos , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
OBJECTIVE: To determine the risk factors and outcome for survival of gynecologic oncology patients in the surgical intensive care unit (SICU). STUDY DESIGN: A chart review from January 1987 through May 1992 yielded 73 gynecologic oncology patients with a malignancy who had undergone surgery with a minimum stay of three days in the SICU. Of these 73 patients, 49 patients died of malignancy, 5 were alive with disease, and 19 were alive without evidence of disease. RESULTS: The median survival of the 73 patients was 123 days; that of 48 ovarian cancer patients was 50 days. Twenty patients (27.4%) died in the hospital. CONCLUSION: This study, with multivariate analysis, showed that multiple medical conditions, especially cardiac disease, and a stay of longer than five days in the SICU had a significant impact on survival, with ovarian cancer patients staying longer and having poorer survival. These results will help in triaging patients for postsurgical management.
Asunto(s)
Neoplasias de los Genitales Femeninos/cirugía , Unidades de Cuidados Intensivos , Tiempo de Internación , Resultado del Tratamiento , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Neoplasias de los Genitales Femeninos/mortalidad , Neoplasias de los Genitales Femeninos/patología , Costos de la Atención en Salud , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Ováricas/mortalidad , Neoplasias Ováricas/patología , Neoplasias Ováricas/cirugía , Pronóstico , Tasa de SupervivenciaRESUMEN
OBJECTIVE: To delineate costs between various obstetric and gynecologic (OB/GYN) patients with stays in the surgical intensive care unit (SICU). STUDY DESIGN: A chart review identified 86 OB/GYN patients who had a minimum SICU stay of three days between January 1987 and May 1992. RESULTS: Our study showed that the total cost of these cases was $3,344,010, with a median of $29,780 (range, $20,230-180,610) and that the difference between patients with malignancies and those without (median, $20,340) was not statistically significant (P = .11). However, cases of malignant disease that had either a prexisting medical condition or an SICU stay of more than five days cost more than any other cases (P = .038). The SICU share of total hospital cost ranged from 20.7% in patients with malignancy to 40% in patients without malignancy. CONCLUSION: As health care costs come under closer scrutiny, the critically ill patient should not be placed at risk of lessened chances of survival because perceived savings result in decreasing quality of care.