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2022-RA-676-ESGO Utilization of Ligasure Maryland Jaw open sealer/divider with nanocoating improves perioperative parameters in women with advanced ovarian cancer subjected to cytoreductive surgery
  1. Dimitrios Tsolakidis,
  2. Kimon Chatzistamatiou,
  3. Dimitrios Zouzoulas,
  4. Efthalia Markopoulou,
  5. Stavros Mpischiniotis,
  6. Eleni Mpili,
  7. Themistoklis Mikos,
  8. George Pados and
  9. Grigorios Grimbizis
  1. st Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece


Introduction/Background Cytoreductive surgery is a pivotal treatment for women with advanced ovarian cancer. Optimal cytoreduction aims to achieve no visible tumor or residual disease less than 1 cm. This surgical procedure often has high morbidity due to the surgical complexity. The objective of the presented analysis is to identify whether using the Ligasure® Maryland-jaw open sealer/divider (LMjsd) with nanocoating facilitates cytoreductive surgery by reducing intraoperative bleeding and therefore other parameters regarding hospitalization.

Methodology Women with stage III/IV ovarian cancer who were referred to the Department of Gynaecologic Oncology, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Thessaloniki, Greece, and were subjected to primary/interval cytoreductive surgery were retrospectively allocated into two distinct groups, depending on whether the LMjsd was used or not. The comparison focused on differences between the two groups regarding intraoperative blood loss and blood transfusion, duration of surgery, blood transfusion within the post-operative course, Intensive Care Unit (ICU) and overall hospital length of stay.

Results Between January 2012 and April 2022, 306 ovarian cancer patients were surgically treated; of these, 230 were stage III/IV. In the group of women (N=56), who were operated on using the LMjsd, duration of surgery (p<0.001) was increased, but blood loss (p<0.001) during surgery was significantly decreased compared to cases treated without the LMjsd (N=174). The intra-operative blood transfusion rate, but not the amount of transfused packed red blood cells (p=0.752), was significantly decreased in the first group (p=0.032), whereas post-operative blood transfusion rate was not affected (p=0.063). Moreover, ICU and overall hospital length of stay were significantly decreased in cases where the LMjsd was used (p<0.001 for both parameters).

Conclusion The LMjsd is associated to less intra-operative bleeding and transfusion rates; ICU and overall hospital length of stay is improved in women subjected to cytoreductive surgery for advanced ovarian cancer.

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