{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:18:44Z","timestamp":1787840324136,"version":"build-2784847793"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We performed preoperative evaluations of giant ovarian tumors in older adult patients using the comprehensive geriatric assessment (CGA) and estimation of physiologic ability and surgical stress (E-PASS) scoring systems. We report a case in which the Aron Alpha method was performed, and perioperative management was performed using enhanced recovery after surgery (ERAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>We performed preoperative evaluations using the E-PASS scoring system and CGA on older adult patients with giant ovarian tumors, followed by the minimally invasive Aron Alpha method and perioperative management using ERAS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The mean patient age was 75.8 \u00b1 8.8 years; comorbidities included hypertension in three patients, hyperlipidemia in two, angina pectoris in one, cholecystitis in one, and lower extremity varicose veins in one. The mean tumor size was 21.0 \u00b1 5.4 cm. The E-PASS scoring system showed a preoperative risk score of 0.7 \u00b1 0.4, a surgical stress score of 0, and a comprehensive risk score of 0.3 \u00b1 0.3. CGA showed that two patients had problems with activities of daily living and cognitive function. The mean duration of surgery was 89.0 \u00b1 16.6 min, and the mean blood loss was 56.0 \u00b1 65.4 mL. No surgery-associated complications were observed. No patients had prolonged hospitalization or a decline in activities of daily living.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We showed the usefulness of performing detailed preoperative evaluations using CGA and the E-PASS system, followed by the minimally invasive Aron Alpha surgical method and perioperative management using ERAS in improving surgical outcomes in older adult patients with giant ovarian tumors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/gmit.gmit_77_23","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T04:00:38Z","timestamp":1728446438000},"page":"215-220","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Management of Large Ovarian Tumors in Elderly Patients Using the Aron Alpha Method and Principles of Enhanced Recovery after Surgery"],"prefix":"10.4103","volume":"13","author":[{"given":"Kaoru","family":"Kakinuma","sequence":"first","affiliation":[{"name":"Graduate School of Medicine, International University of Health and Welfare, Narita-City, Chiba, Japan"},{"name":"Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City, Tochigi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Kakinuma","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City, Tochigi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaka","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City, Tochigi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Takeshima","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City, Tochigi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaoru","family":"Yanagida","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City, Tochigi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michitaka","family":"Ohwada","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City, Tochigi, 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