title: Safety and efficacy of video laparoscopic surgical debulking of recurrent ovarian, fallopian tube, and primary peritoneal cancers.
abstract: OBJECTIVE
  Studies on the role of laparoscopy in secondary or tertiary cytoreduction for recurrent ovarian cancer are limited. Our objective is to describe our preliminary experience with laparoscopic secondary/tertiary cytoreduction in patients with recurrent ovarian, fallopian, and primary peritoneal cancers.
  
  
  METHODS
  This is a retrospective analysis of a prospective case series. Women with recurrent ovarian, fallopian tube, or primary peritoneal cancers deemed appropriate candidates for laparoscopic debulking by the primary surgeon(s) were recruited. The patients underwent exploratory video laparoscopy, biopsy, and laparoscopic secondary/tertiary cytoreduction between June 1999 and October 2009. Variables analyzed include stage, site of disease, extent of cytoreduction, operative time, blood loss, length of hospital stay, complications, and survival time.
  
  
  RESULTS
  Twenty-three patients were recruited. Only one surgery involved conversion to laparotomy. Seventeen (77.3%) of the patients had stage IIIC disease at the time of their initial diagnosis, and 20 (90.9%) had laparotomy for primary debulking. Median blood loss was 75 mL, median operative time 200 min, and median hospital stay 2 d. No intraoperative complications occurred. One patient (4.5%) had postoperative ileus. Eighteen (81.8%) of the patients with recurrent disease were optimally cytoreduced to 1cm. Overall, 12 patients have no evidence of disease (NED), 6 are alive with disease (AWD), and 4 have died of disease (DOD), over a median follow-up of 14 mo. Median disease-free survival was 71.9 mo.
  
  
  CONCLUSIONS
  In a well-selected population, laparoscopy is technically feasible and can be utilized to optimally cytoreduce patients with recurrent ovarian, fallopian, or primary peritoneal cancers.
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA. frn2103@columbia.edu
authors.forename: Farr R
authors.initials: FR
authors.lastname: Nezhat
authors.forename: Shaghayegh M
authors.initials: SM
authors.lastname: Denoble
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Cho
authors.forename: Douglas N
authors.initials: DN
authors.lastname: Brown
authors.forename: Enrique
authors.initials: E
authors.lastname: Soto
authors.forename: Linus
authors.initials: L
authors.lastname: Chuang
authors.forename: Herbert
authors.initials: H
authors.lastname: Gretz
authors.forename: Prakash
authors.initials: P
authors.lastname: Saharia
mesh_terms: D001706:Biopsy; D000077216:Carcinoma, Ovarian Epithelial; D018572:Disease-Free Survival; D005185:Fallopian Tube Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D020535:Video-Assisted Surgery / Q000379:methods*