# Evaluation of Factors Associated with Pulmonary Complications in Patients Undergoing Surgery for Epithelial Ovarian Cancer

## TL;DR

This study identifies factors linked to lung complications after surgery for ovarian cancer, aiming to improve patient outcomes.

## Contribution

The study provides insights into risk factors for pulmonary complications in epithelial ovarian cancer surgery.

## Key findings

- Pulmonary complications occurred in 13.4% of patients after surgery for epithelial ovarian cancer.
- Smoking and diaphragm peritonectomy were significantly associated with higher rates of pulmonary complications.
- Surgery duration and postoperative hospital stay showed high sensitivity and specificity for predicting complications.

## Abstract

Background: Ovarian cancer surgery requires multiple radical resections with a high risk of complications. The objective of this single-centre, retrospective study was to identify the factors associated with pulmonary complications following cytoreduction. Methods: The study included 179 patients who underwent surgery at the gynaecological oncology department of the Antalya Training and Research Hospital between January 2015 and December 2021. A univariate analysis was performed to identify significant risk factors for postoperative pulmonary complications. The data obtained were then subjected to multivariate analysis to determine the relative importance of each factor. Results: A total of 176 ovarian cancer patients underwent cytoreductive surgical procedures for epithelial ovarian cancer (EOC) during the study period. Postoperative pulmonary complications (PPCs) occurred in a total of 24 patients (13.4%). Of the complications observed, n = 18 (10.06%) were pulmonary effusion, n = 5 (2.79%) were pulmonary thromboembolism, n = 1 (0.56%) was pneumo-mediastinum, n = 6 (3.35%) were pulmonary oedema, and n = 1 (0.56%) was transfusion-related lung injury (TRALI). Pulmonary complication rates were 6.512 times higher in patients who underwent diaphragm peritonectomy (p = 0.014) and 26.1 times higher in smokers (p = 0.005). When an ROC analysis was performed for quantitative parameters related to pulmonary complications, the sensitivity and specificity of the duration of surgery were 83.3% and 64.5%, respectively, and the sensitivity and specificity of the duration of postoperative hospital stay were 79.2% and 67.5% (p < 0.001, p < 0.001, p < 0.001, p < 0.001). Conclusions: An improved understanding of the multifactorial aetiology of PPCs and the development of an appropriate perioperative management strategy may serve to mitigate the negative impact of these complications, thereby contributing to an enhancement in patient outcomes.