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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2007

01-06-2007 | Gynecologic Oncology

Determination of the Necessary Total Protein Substitution Requirements in Patients with Advanced Stage Ovarian Cancer and Ascites, Undergoing Debulking Surgery. Correlation with Plasma Proteins

Authors: George Vorgias, MD, PhD, Christos Iavazzo, MD, John Mavromatis, MD, Joanna Leontara, MD, Michael Katsoulis, MD, PhD, Nickolas Kalinoglou, MD, Thrassivoulos Akrivos, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2007

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Abstract

Background

Ascites is common in patients with advanced ovarian carcinoma (AOC). Its drainage during surgery affects plasma proteins. We sought to correlate the volume of ascites with the oncological parameters of the disease, calculate its drainage effect on plasma proteins, and determine the necessary substitution requirements and a clinical way of achieving that.

Patients and Methods

We evaluated 138 patients with AOC and ascites who underwent primary cytoreductive surgery. Intraoperatively found ascites and its postoperative production were evaluated. Its drainage effect on plasma proteins and the substitution requirements were determined using a mathematic formula. Human albumin(HA) and fresh frozen plasma (FFP) were used to cover these requirements.

Results

The intraoperative ascites was found to correlate only with the stage of the disease, while its postoperative production correlated with the residual disease. Optimally debulked patients had a mean ascites production of 128 mL on postoperative day 1 compared with 668 mL of the suboptimally debulked. This production required 3 and 5–7 days, respectively, to drop <50 mL. Plasma proteins fell on their minimum level (88.9 versus 80.8%) on the second postoperative day. The protein deficit was calculated to be 379 and 691 g/day, respectively. This deficit was substituted by administering 2 HA and 2 FFP for 3–6 days.

Conclusions

Ascites drainage affects the postoperative homeostasis of plasma proteins. A mean acute drop of 12–20% is monitored on postoperative day 2. This deficit can be managed with HA and FFP for a minimum of 3 days.
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Metadata
Title
Determination of the Necessary Total Protein Substitution Requirements in Patients with Advanced Stage Ovarian Cancer and Ascites, Undergoing Debulking Surgery. Correlation with Plasma Proteins
Authors
George Vorgias, MD, PhD
Christos Iavazzo, MD
John Mavromatis, MD
Joanna Leontara, MD
Michael Katsoulis, MD, PhD
Nickolas Kalinoglou, MD
Thrassivoulos Akrivos, MD, PhD
Publication date
01-06-2007
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 6/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-007-9404-x

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