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In the present study, postoperative complications and anastomotic leakage were investigated before and after implementation of pulse pressure variation-guided fluid management (PPVGFM) during ovarian cancer surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Patients and Methods<\/jats:title>\n                <jats:p>A total of <jats:italic>n\u2009<\/jats:italic>=\u2009243 patients with ovarian cancer undergoing cytoreductive surgery at the University Hospital Bonn were retrospectively evaluated. Cohort A (CA; <jats:italic>n\u2009<\/jats:italic>=\u2009185 patients) was treated before and cohort B (CB; <jats:italic>n\u2009<\/jats:italic>=\u200958 patients) after implementation of PPVGFM. Both cohorts were compared regarding postoperative complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Ultrasevere complications (G4\/G5) were exclusively present in CA (<jats:italic>p\u2009<\/jats:italic>=\u20090.0025). No difference between cohorts was observed regarding severe complications (G3\u2013G5) (<jats:italic>p\u2009<\/jats:italic>=\u20090.062). Median positive fluid excess was lower in CB (<jats:italic>p\u2009<\/jats:italic>=\u20090.001). This was independent of tumor load [peritoneal cancer index] (<jats:italic>p\u2009<\/jats:italic>=\u20090.001) and FIGO stage (<jats:italic>p\u2009<\/jats:italic>=\u20090.001). Time to first postoperative defecation was shorter in CB (CB: d2 median versus CA: d3 median; <jats:italic>p\u2009<\/jats:italic>=\u20090.001). CB had a shorter length of hospital stay (<jats:italic>p\u2009<\/jats:italic>=\u20090.003), less requirement of intensive medical care (<jats:italic>p\u2009<\/jats:italic>=\u20090.001) and postoperative ventilation (<jats:italic>p\u2009<\/jats:italic>=\u20090.001). CB received higher doses of noradrenalin (<jats:italic>p\u2009<\/jats:italic>=\u20090.001). In the combined study cohort, there were more severe complications (G3\u2013G5) in the case of a PFE\u2009\u2265\u20093000\u00a0ml (<jats:italic>p\u2009<\/jats:italic>=\u20090.034) and significantly more anastomotic leakage in the case of a PFE\u2009\u2265\u20094000\u00a0ml (<jats:italic>p\u2009<\/jats:italic>=\u20090.006).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Intraoperative fluid reduction in ovarian cancer surgery according to a PPVGFM is safe and significantly reduces ultrasevere postoperative complications. PFEs of\u2009\u2265\u20093000\u00a0ml and\u2009\u2265\u20094000\u00a0ml were identified as cutoffs for significantly more severe complications and anastomotic leakage, respectively.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1245\/s10434-024-16246-0","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T17:02:02Z","timestamp":1728406922000},"page":"8944-8951","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Intraoperative Fluid Balance and Perioperative Complications in Ovarian Cancer Surgery"],"prefix":"10.1245","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9891-3996","authenticated-orcid":false,"given":"Eva K.","family":"Egger","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janina","family":"Ullmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Hilbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damian J.","family":"Ralser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Tascon","family":"Padron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milka","family":"Marinova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Stope","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Mustea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,8]]},"reference":[{"issue":"3","key":"16246_CR1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. 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