Do critical care units play a role in the management of gynaecological oncology patients? The contribution of gynaecologic oncologist in running critical care units

Eur J Cancer Care (Engl). 2017 Mar;26(2). doi: 10.1111/ecc.12438. Epub 2016 Jan 25.

Abstract

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.

Keywords: admission; gynaecological oncology surgery; high dependency unit; intensive care unit; outcome.

Publication types

  • Review

MeSH terms

  • Critical Care
  • Disease Management
  • Female
  • Genital Neoplasms, Female / therapy*
  • Gynecology*
  • Hospital Costs
  • Humans
  • Intensive Care Units*
  • Length of Stay
  • Physician's Role
  • Postoperative Care*
  • Surgical Oncology*