Impact of introducing a PACU24 concept on the perioperative outcome of patients with advanced ovarian cancer treated with cytoreductive surgery

Introduction/Background Patients with ovarian cancer in need of multivisceral surgery usually require intensive care monitoring postoperatively. In view of the increasingly strained resources with regard to intensive care beds and the introduction of fast-track treatment concepts, it has recently been suggested that these patients should be cared for postoperatively in 24-h Post Anesthesia Care Units (PACU24). So far, no analyses investigating whether such a postoperative care concept might be associated with an increase in postoperative complications have been published.

Methodology A PACU24 unit was implemented in our institution in 2015 and became the standard care pathway for patients with ovarian cancer. In this retrospective analysis data from patients treated before (control group, n=45) and after (PACU group, n=42) the introduction of this care concept have been compared with particular focus on postoperative complications and secondary admission to an intensive care unit whenever necessary.

Results The preoperative and surgical data of both groups were comparable (Age, ASA, BMI, FIGO stage, duration of surgery, blood loss). Patients in the PACU group underwent bowel resection with anastomosis significantly more often (76.3% vs. 33.3%, p < 0.001), although the extent of surgery was otherwise comparable. The total number, type and severity of postoperative complications and the duration of the overall stay in hospital did not differ between these two groups. None of the patients required secondary transfer from PACU or normal ward to an intensive care unit (ICU).

Conclusion Our data support the assumption that the care concept of transferring patients to a PACU24 represents a safe and cost-saving pathway for the postoperative care of patients even after complex gynecological-oncological procedures.

Disclosures All authors declare no conflict of interests.