title: [Urinary tract surgery in patients with ovarian peritoneal carcinomatosis treated with cytoreduction and hyperthermic intraoperative intraperitoneal chemotherapy].
abstract: BACKGROUND
  The objective of the present work is to describe our experience in the surgery of the ureter and bladder in patients with primary and recurrent ovarian cancer subjected to peritonectomy procedures and the administration of hyperthermic intraoperative intraperitoneal chemotherapy (HIIC).
  
  
  METHODS
  Those patients who required surgical procedures on the distal ureter or bladder, were selected from a prospective data base constructed at the beginning of the peritoneal carcinomatosis program in our centre. Seven patients fulfilled this requirement and were included in the study. A total of 81 patients diagnosed with primary or recurrent ovarian cancer from December 2007 to April 2011 were included for maximum effort cytoreduction and HIIC.
  
  
  RESULTS
  It was necessary to perform some surgical manoeuvre on the ureter or bladder in seven patients, with a median age of 46 years (40-71). Four patients were operated on due to recurrence of the ovarian disease and in the other 3 patients the indication was surgical rescue after non-optimal surgery in another centre. There was direct tumour involvement of the lower urinary tract in 4 of them. Three patients (42%) in the series developed at least one postoperative complication.
  
  
  CONCLUSIONS
  The performing of peritonectomy procedures that include the eventual resection of the ureter or bladder, and the subsequent application of HIIC in a selected group of patients with peritoneal dissemination due to an ovarian carcinoma can be done with reasonable rates of postoperative morbidity. These surgical procedures may be necessary to achieve optimal surgery.
authors.affiliation: Unidad de Cirugía de la Carcinomatosis Peritoneal, Departamento de Cirugía General y Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, Murcia, España. cascalex@yahoo.es
authors.forename: Pedro Antonio
authors.initials: PA
authors.lastname: Cascales
authors.forename: José
authors.initials: J
authors.lastname: Gil
authors.forename: Cristóbal Moreno
authors.initials: CM
authors.lastname: Alarcón
authors.forename: Pedro
authors.initials: P
authors.lastname: Galindo
authors.forename: Guillermo
authors.initials: G
authors.lastname: Gómez
authors.forename: Pascual
authors.initials: P
authors.lastname: Parrilla
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D010478:Chemotherapy, Cancer, Regional Perfusion; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007432:Intraoperative Period; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D010534:Peritoneal Neoplasms / Q000601:surgery*; D011446:Prospective Studies; D013520:Urologic Surgical Procedures