Surgical risk assessment for gynecological oncologic patients/Jinekolojik onkoloji hastalarda cerrahi risk degerlendirmesi

• Published in: Turkish journal of obstetrics and gynecology 2019-09, Vol.16 (3), p.158
• Main Authors: Bicer, Caglayan, Raoufi, Jalal, Iscan, Serhan Can, Guney, Mehmet, Erdemoglu, Evrim
• Format: Article
• Language: English
• Subjects: Albumin; Antigens; Ascites; Cancer; Cancer patients; Cancer research; Carcinoma; Diabetes mellitus; Health aspects; Heart; Lung diseases; Morbidity; Mortality; Respiratory tract diseases; Risk assessment; Surgery; Urinary tract infections
• ISSN: 2149-9322
• DOI: 10.4274/tjod.galenos.2019.93584

Objective: Preoperative surgical risk assessment is important in terms of postoperative morbidity and mortality. Therefore, it is necessary to evaluate the efficacy and safety of these surgeries via an ideal risk assessment model, and reduce risks via applying some findings (for instance, perioperative beta-blockers). There are some risk assessment systems, but these have generally not been verified for patients with gynecologic cancer. The aim of this study was to assess the risk of surgery for gynecological oncologic patients and suggest an easy risk assessment model and risk reduction by applying our findings. Materials and Methods: We retrospectively analyzed 258 gynecologic patients with cancer. Age, diagnosis, staging, performance scale, metoprolol use, heart, renal diabetes, Chronic Obstructive Pulmonary disease, diabetes, operation type and length, carcinoma antigen 125, ascites, albumin, surgical procedure, hospitalization length, and complications were recorded. Results: Of the 258 patients, 173 patients (67.1%) had no complications, 43 patients (16.7%) had one and 42 patients (16.3%) had two or more complications. The most common complication was the acid-base imbalance (14%), followed by urinary tract infection (9.7%). Parameters associated with complications were performance status, ascites, operating length, metoprolol use, and upper abdominal surgery. In our proposed scoring model with a total score range 0-23, cut-off value points for both the presence and rate of complications was found as >5. Conclusion: In gynecological patients with cancer, the addition of metoprolol use and upper abdominal surgery within preoperative risk assessment evaluation parameters are significantly effective in predicting the rate and severity of complications. Moreover, we have suggested a simple, practical, and convenient scoring model for this evaluation. Keywords: Gynecological oncology, metoprolol, upper abdominal surgery, surgical risk assessment Amac: Cerrahi risk degerlendirilmesi, cerrahi islem sirasinda ve sonrasinda morbidite ve mortalite acisindan onem tasimaktadir. Risk degerlendirmeleriyle cerrahi tedavinin etkinligi ve guvenligi belirlenerek, gerektiginde risk azaltici prosedurler uygulanabilir (ornegin beta bloker kullanimi). Gunumuzde kullanilan bazi risk degerlendirme sistemleri bulunsa da jinekolojik kanser hastalarinda kabul edilmis bir sistem bulunmamaktadir. Bu calismanin amaci jinekolojik onkoloji hastalarinda kolay uygulanacak risk degerl