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.
Summa Health System, Northeastern Ohio Universities College of Medicine, Akron, Ohio 44304, USA. Fanningj@summa-health.org
James
J
Fanning
Rod
R
Hojat
Jil
J
Johnson
Bradford
B
Fenton
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