Introduction/Background*Surgery in gynecological cancer remains one of the primary modalities of treatment . The procedures are now standardized and online video libraries are a source of knowledge and training for young surgeons. This accumulation of knowledge has promoted the surgical skills and increased the radicality of the procedures, especially in debulking surgeries that are now extended in upper abdomen or even the thoracic cavity. This increased radicality inevitable increases the complications during and after surgery.

Methodology We retrospectively reviewed the all cases of abdominal surgery open or laparoscopically from 2017-2020. Patients that was included in the Enhanced Recovery After Surgery Protocol were excluded in order to avoid bias in our outcomes. The parameters that were documented were intraoperative complications, complications during the hospitalization of the patient, readmission of patients, reoperation of patients, patients’ comorbidities, the charlson comorbidity index (CCI) and body mass index(BMI) . Secondary events were classified according to the Clavien Dindo classification.

Result(s)*In total 1006 patients records were reviewed. 438 (43,3%) were in patients with advanced stage disease. Mean CCI was 3,5 and BMI 28,78. Class 1 and 2 complication rates were documented in 193 patients (19,1%) . The mean hospitalization times of these patients were 13,1 days in contrast to the uncomplicated patients that was 3,53 days.

Class 3 complications were documented in 54 cases (5,36%). 19 cases were reoperated. The reasons for reoperation were massive hemorrhage in 3 cases, urinary tract complication in 6 cases, surgical wound dehiscence in 5 cases and 5 cases of gastrointestinal tract leakage.

Totally, 12 patients succumbed after surgery. 4 of the patients were emergency operations due to peritonitis, 2 patients succumbed due to complications from respiratory tract infections, in 3 cases from sepsis due to leakage from the gastrointestinal tract and 3 patients from cardiovascular events.

Conclusion*The increased radicality of gynecological oncology procedures increase hospitalization days as well as the perioperative morbidity and mortality.