Key result
Routine post-operative critical care may reduce long-term morbidity and mortality in high-risk gynecological oncology patients.
Dependency care is an integral part of surgical management for high-risk gynaecological oncology patients and should be formally incorporated into training programs.
May support selective critical care use in high-risk cases; leaves open prospective trials on training integration and costs.
Routine post-operative care in high dependency unit (HDU), surgical intensive care unit (SICU) and intensive care unit (ICU) after high-risk gynaecological oncology surgical procedures may allow for greater recognition and correct management of post-operative complications, thereby reducing long-term morbidity and mortality. On the other hand, unnecessary admissions to these units lead to increased morbidity - nosocomial infections, increased length of hospital stay and higher hospital costs. Gynaecological oncology surgeons continue to look after their patient in the HDU/SICU and have the final role in decision-making on day-to-day basis, making it important to be well versed in critical care management and ensure the best care for their patients. Post-operative monitoring and the presence of comorbid illnesses are the most common reasons for admission to the HDU/SICU. Elderly and malnutritioned patients, as well as, bowel resection, blood loss or greater fluid resuscitation during the surgery have prolonged HDU/SICU stay. Patients with ovarian cancer have a worse survival outcome than the patients with other types of gynaecological cancer. Dependency care is a part of surgical management and it should be incorporated formally into gynaecologic oncology training programme.
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Davidovic-Grigoraki et al. (2016) conducted a review in Gynaecological oncology. Critical care unit management was evaluated. Routine post-operative care in critical care units for high-risk gynaecological oncology patients may reduce long-term morbidity and mortality, though unnecessary admissions increase hospital costs.
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