Intraoperative Collection of Ascitic Fluid With Intra‐ or Postoperative Reinfusion in Ovarian Cancer: Safety and Feasibility of a Roller Pumping Method

INTRODUCTION: Patients with ovarian cancer often present with massive ascites, leading to significant protein loss during surgical procedures. Although cell-free concentrated ascites reinfusion therapy (CART) is used in palliative settings to mitigate protein loss, its application in intraoperative settings remains unexplored. METHODS: We retrospectively evaluated patients who underwent intraoperative CART for ovarian cancer treatment between March 2022 and 2025, compared two ascitic fluid collection methods (syringe and roller pumping), and analyzed operative parameter, fluid collection efficiency, albumin recovery, and adverse event-related data. RESULTS: Among the 12 patients included in this study, seven (58.3%) underwent CART using the roller pumping method, which significantly reduced the collection time compared with the syringe method (9 vs. 22 min, p < 0.05). The median collection speed was also significantly higher with the roller pumping method (404 vs. 140 mL/min, p < 0.05). Approximately 70% of the albumin in the collected ascitic fluid was successfully reinfused. Adverse events included transient hypotension (16.7%) and hypertension (25.0%), both of which resolved without intervention. CONCLUSION: Intraoperative CART is a feasible and safe technique for protein loss management in patients undergoing surgery for ovarian cancer. The roller pumping method significantly shortened ascites collection time and reduced surgical burden.