title: Laparoscopic-assisted cytoreduction for primary advanced ovarian cancer: success, morbidity and survival.
abstract: OBJECTIVE
  The purpose of this paper is to evaluate laparoscopic-assisted cytoreduction for primary advanced ovarian cancer: feasibility, morbidity, response to chemotherapy and survival.
  
  
  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 five port (5-mm) transperitoneal approach was used. A bilateral salpingo-oophorectomy, supracervical hysterectomy and omentectomy were performed with the 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
  Twenty-three cases (92%) were successfully cytoreduced laparoscopically without conversion to laparotomy. Median operative time was 2.3h and median blood loss was 340 cc. All tumors were debulked to less than 2 cm and 36% had no residual disease. Median length of stay was 1 day. Median VAS pain score was 4-discomforting. Six patients (24%) had post-operative complications, none grades 3-4. Median overall survival is 3.5 years.
  
  
  CONCLUSIONS
  Laparoscopic-assisted cytoreduction for primary advanced ovarian cancer was successful, resulting in minimal morbidity, and acceptable survival.
authors: Pennsylvania State University, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hershey, PA 17033, United States. jfanning1@hmc.psu.edu
authors: James
authors: J
authors: Fanning
authors: Emmanuel
authors: E
authors: Yacoub
authors: Rod
authors: R
authors: Hojat
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D009017:Morbidity; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome