Laparoscopic cytoreduction for primary advanced ovarian cancer.
BACKGROUND
We evaluated the feasibility of laparoscopic cytoreduction for primary advanced ovarian cancer.


METHODS
All patients with presumed stage 3/4 primary ovarian cancer underwent attempted laparoscopic cytoreduction. All patients had CT evidence of omental metastasis and ascites. A 5-port (5-mm) transperitoneal approach was used. A bilateral salpingo-oophorectomy, supracervical hysterectomy, and omentectomy were performed with PlasmaKinetic (PK) cutting forceps. A laparoscopic 5-mm Argon-Beam Coagulator was used to coagulate tumor in the pelvis, abdominal peritoneum, intestinal mesentery, and diaphragm.


RESULTS
Nine of 11 cases (82%) were successfully debulked laparoscopically without conversion to laparotomy. Median operative time was 2.5 hours, and median blood loss was 275 mL. All tumors were debulked to <2 cm and 45% had no residual disease. Stages were 1-3B, 7-3C, and 1-4. Median length of stay was one day. Median VAS pain score was 4 (discomforting). Two of 11 patients (18%) had postoperative complications.


CONCLUSIONS
Laparoscopic cytoreduction was successful and resulted in minimal morbidity. Because of our small sample size, additional studies are needed.
Fanning
James
J
Summa Health System, Northeastern Ohio Universities College of Medicine, Akron, Ohio 44304, USA. Fanningj@summa-health.org
Hojat
Rod
R
Johnson
Jil
J
Fenton
Bradford
B
D000368:Aged; D005240:Feasibility Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy / Q000379:methods*; D017075:Laser Coagulation; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D010052:Ovariectomy / Q000379:methods*; D016896:Treatment Outcome