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Open abdominal vacuum pack technique for the management of severe abdominal complications after cytoreductive surgery in ovarian cancer.
Navarro, Anne-Sophie; Gomez, Carlos Martinez; Angeles, Martina Aida; Fuzier, Régis; Ruiz, Jean; Picard, Muriel; Martinez, Alejandra; Ferron, Gwénaël.
Afiliación
  • Navarro AS; Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT) - Oncopole, Toulouse, France. Electronic address: Navarro.annesophie@iuct-oncopole.fr.
  • Gomez CM; Department of Surgical Oncology, Institut Oscar Lambret, Lille, France.
  • Angeles MA; Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT) - Oncopole, Toulouse, France.
  • Fuzier R; Department of Anesthesia Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT) - Oncopole, Toulouse, France.
  • Ruiz J; Intensive care unit, Institut Universitaire du Cancer de Toulouse (IUCT) - Oncopole, CHU Toulouse, Toulouse, France.
  • Picard M; Intensive care unit, Institut Universitaire du Cancer de Toulouse (IUCT) - Oncopole, CHU Toulouse, Toulouse, France.
  • Martinez A; Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT) - Oncopole, Toulouse, France.
  • Ferron G; Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT) - Oncopole, Toulouse, France.
Gynecol Oncol ; 170: 108-113, 2023 03.
Article en En | MEDLINE | ID: mdl-36681011
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Ováricas / Productos Biológicos / Terapia de Presión Negativa para Heridas / Técnicas de Cierre de Herida Abdominal / Traumatismos Abdominales Tipo de estudio: Etiology_studies / Observational_studies Límite: Female / Humans Idioma: En Revista: Gynecol Oncol Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Ováricas / Productos Biológicos / Terapia de Presión Negativa para Heridas / Técnicas de Cierre de Herida Abdominal / Traumatismos Abdominales Tipo de estudio: Etiology_studies / Observational_studies Límite: Female / Humans Idioma: En Revista: Gynecol Oncol Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos