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Introduction/Background* Complete cytoreduction is the cornerstone of the treatment for advanced ovarian cancer (AOC). To achieve this goal multiple organ resection is required, with an important impact on the patient’s overall health. These patients may benefit from the implementation of enhanced recovery after surgery (ERAS). The aim of this study is to evaluate the possible benefit in the patient’s postoperative morbidity. Methodology Retrospective analysis of women with AOC from the 1st Department of Obstetrics & Gynecology AUTh at “Papageorgiou” Hospital (ESGO Certified Center for AOC), 2014 – 2019. From 2014 to 2016 conventional management (CM) was applied, while from 2017 to 2019 patients where managed with ERAS protocol. Patient & tumor characteristics, treatment options and follow-up information were collected. Primary outcomes where ICU admittance, post-operative complications (Clavien – Dindo classification) and hospitalization. Result(s)* 142 patients met the inclusion criteria. Patients underwent either primary debulking surgery (PDS) or interval debulking surgery (IDS). 84 patients were treated with conventional management and 58 with ERAS protocol. The mean age for the ERAS group was 60 ± 13 vs. 61 ± 13 years old for the CM group (p=0.8315). Furthermore, there was no difference between the type of surgery operation duration between the 2 groups. (CM group: 210min vs. ERAS group: 240min, p=0.1497/CM group: 50% PDS – 50% IDS vs. ERAS group: 38% PDS – 62% IDS, p=0.1554). However, the occurrence of ICU admittance (32% vs. 14%, p=0.01263), overall postoperative complications (32 vs. 22.6, p=0.004) and hospitalization (9 vs. 7 days, p Conclusion* The implementation of the ERAS program in the management of AOC improves patient’s postoperative morbidity, reducing the interval time between surgery and systematic therapy. Less need for the ICU and fewer days in the hospital can decrease healthcare costs in high-volume gynecological – oncological centers.

Introduction/Background* Complete cytoreduction is the cornerstone of the treatment for ovarian cancer (OC). Patients are triaged either for primary debulking surgery (PDS) or neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS), based on the preoperative assessment. The aim of this study is to evaluate the impact of the enhanced recovery after surgery (ERAS) protocol in postoperative morbidity for both groups (PDS vs. IDS). Methodology Retrospective analysis of women with OC from the 1st Department of Obstetrics &amp Gynecology AUTh at ‘Papageorgiou’ Hospital (ESGO Certified Center for AOC), 2017 – 2019. Patients were triaged for PDS or IDS based on preoperative imaging and ‘laparoscopic Fagotti’s score’. Patient & tumor characteristics, treatment options and follow-up information were collected. Primary outcomes were ICU admittance, post-operative complications (Clavien – Dindo classification) and duration of hospitalization. Result(s)* 78 patients met the inclusion criteria: 40 underwent PDS and 38 IDS. The two groups had no significant difference in patients characteristics (age, Charlson comorbidity index (CCI)). Furthermore, concerning surgical outcomes PDS vs IDS group had higher surgical complexity score (SCS), blood loss and complete debulking rate, but with no statistical significance (5 vs. 4, p=0.1466/350 vs. 300, p=0.1197/77.5% vs. 68.4%, p=0.5958 respectively). Only the duration of the surgery was statistically significant in the PDS group (300 vs. 195 min, p = 0.007). The implementation of the ERAS protocol led to comparable results with no statistical significance for postoperative morbidity, between the two groups: The PDS group had higher ICU admittance (17.5% vs. 2.6%, p=0.9741), lower overall complications (15 vs. 19, p=0.9741) and the same hospitalization (8 ± 3 vs. 8 ± 2.8 days, p=0.3805). Conclusion* Careful preoperative selection of patients and the implementation of the ERAS program in the management of OC results in comparable postoperative morbidity between PDS and IDS, regardless of the higher SCS in the upfront surgery or the toxicity of the NACT. Further prospective studies are needed to validate these results.

Introduction/Background* Cytoreductive surgery is the cornerstone treatment in the armamentarium for women with advanced ovarian cancer. The goal of successful cytoreduction is achiving no visible tumor or residual disease less than 1 cm. This prerequisite is a demanding process with high morbidity, requiring high clinical expertise and enhanced surgical skills. The objective of the presented analysis is to identify whether the usage of the Ligasure® Maryland jaw open sealer/divider (LMjsd) with nanocoating facilitates cytoreductive surgery by reducing intraoperative bleeding and hence other parameters regarding hospitalization. Methodology Women with advanced stage ovarian cancer (stage III or IV) who were referred to the Department of Gynecologic Oncology, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Thessaloniki, Greece, and were subjected to either primary or interval cytoreductive surgery were included in the analysis. Women, who were operated on by the same group of Gynecologic Oncologists, were retrospectively allocated into two distinct groups comprised of women subjected to surgery with or without using the LMjsd. The analysis 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. Result(s)* Between 2012 and 2020, 284 women with ovarian cancer were subjected to surgery; of these, 208 had ovarian cancer stage III or IV. In the group of women (N=34), who were operated on using the LMjsd, duration of surgery, and blood loss during surgery were significantly decreased (p Conclusion* The LMjsd with nanocoating reduces intra-operative bleeding and transfusion rates, and improves duration of surgery, and ICU and overall hospital length of stay in women subjected to cytoreductive surgery for advanced ovarian cancer.