Comparison of perioperative morbidity in patients with ovarian malignancy undergoing radical cancer surgery with or without prior chemotherapy

Evaluation was undertaken of the effect of chemotherapeutic drugs on the pe rioperative morbidity of patients with ovarian malignancy undergoing radica l surgery. Twenty patients who had received cytotoxic drugs pre-operatively (group I) were compared with 11 patients in whom radical surgery was the f irst line of treatment (group IT). Pre and post-operative cardiac, pulmonar y, renal, hepatic and coagulation functions were compared in both groups, a s well as the critical intra- and post-operative events like cardiac pump f ailure, respiratory dysfunction, rhythm disturbances, blood loss, etc. Demo graphic data, ASA status, biochemical and haematological parameters and car diac ejection fractions were comparable in the two groups but patients in g roup I had significantly higher left ventricular end diastolic dimensions ( P<0.01). A higher number of patients in group I had pre-operative respirato ry and coagulation factor abnormalities but critical intra- and post-operat ive events in both groups were comparable. The surgical time was significan tly (P<0.01) longer in group I (5.5+/-2.5 h) as compared to group II (4.5+/ -1.5 h). One patient with extensive tumour spread and pre-operatively deran ged coagulation profile (group I) died of disseminated intravascular coagul ation in the post-operative period. It is concluded that patients with adva nced ovarian malignancy, treated with cytotoxic drugs are more likely to ha ve pre-operative cardiac, respiratory and coagulation abnormalities, which should be managed by thorough pre-operative evaluation and intensive intra- and post-operative monitoring.