Intraoperative hypothermia during primary surgical cytoreduction for advanced ovarian cancer: Risk factors and associations with postoperative morbidity Journal Article


Authors: Long, K. C.; Tanner, E. J.; Frey, M.; Leitao, M. M. Jr; Levine, D. A.; Gardner, G. J.; Sonoda, Y.; Abu-Rustum, N. R.; Barakat, R. R.; Chi, D. S.
Article Title: Intraoperative hypothermia during primary surgical cytoreduction for advanced ovarian cancer: Risk factors and associations with postoperative morbidity
Abstract: Objective The objective of this study was to evaluate the risk factors and potential morbidity associated with intraoperative hypothermia (IH) during cytoreductive surgery (CRS) for advanced ovarian cancer. Methods Demographic and perioperative data were collected for all patients with stage IIIC-IV ovarian, fallopian tube, and primary peritoneal carcinoma who underwent primary CRS at our institution from 2001 to 2010. Only patients with carcinomatosis and/or bulky upper abdominal disease and residual disease of < 1 cm were included. Intraoperative hypothermia was defined as temperature of < 36.0 degrees Celsius (C). Associations with 21 perioperative factors, 12 systems-based complications, and specific complications including but not limited to venous thromboembolism and surgical site infection were evaluated. Results Two hundred ninety-seven patients met the inclusion criteria. An intraoperative temperature < 36 C was noted in 72.1% of patients, and a temperature < 36 C at the time of abdominal closure was noted in 45.5%. Intraoperative vasopressors (P = 0.02), epidural anesthesia (P = 0.01), transfusion of fresh frozen plasma (P < 0.05), and blood loss (P = 0.01) were associated with IH. There was no association between IH and postoperative complications in general (P = 0.48) or specifically grade 3-5 complications (P = 0.34). Univariate analysis did show an association between hematologic complications and IH; however, this did not persist on multivariate analysis (P = 0.14). Conclusions In patients who underwent optimal primary CRS for advanced ovarian cancer, IH alone was not associated with the development of postoperative complications. Postoperative morbidity in these patients is multifactorial and further investigation into modifiable risk factors is warranted. © 2013 Elsevier Inc.
Keywords: adult; human tissue; aged; major clinical study; advanced cancer; cytoreductive surgery; ovary cancer; bleeding; morbidity; risk factor; postoperative complication; minimal residual disease; surgical infection; complications; advanced ovarian cancer; epidural anesthesia; hypothermia; carcinomatosis; hypertensive factor; venous thromboembolism; uterine tube; abdominal disease; fresh frozen plasma; transfusion; human; female; priority journal; article
Journal Title: Gynecologic Oncology
Volume: 131
Issue: 3
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2013-12-01
Start Page: 525
End Page: 530
Language: English
DOI: 10.1016/j.ygyno.2013.08.034
PROVIDER: scopus
PUBMED: 24016410
DOI/URL:
Notes: Export Date: 2 January 2014 -- CODEN: GYNOA -- Source: Scopus
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MSK Authors
  1. Ginger J Gardner
    270 Gardner
  2. Richard R Barakat
    629 Barakat
  3. Dennis S Chi
    707 Chi
  4. Yukio Sonoda
    472 Sonoda
  5. Douglas A Levine
    380 Levine
  6. Mario Leitao
    575 Leitao
  7. Edward James Tanner
    40 Tanner
  8. Melissa Frey
    8 Frey