title: Feasibility and efficacy of laparoscopic restaging surgery for women with unexpected ovarian malignancy.
abstract: OBJECTIVE
  To evaluate the feasibility, surgical outcomes and complications of laparoscopic restaging surgery for women with unexpected ovarian malignancy.
  
  
  METHODS
  We conducted a retrospective chart review of 14 women with unexpected ovarian malignancy who underwent laparoscopic restaging surgery including peritoneal washing cytology, laparoscopic pelvic and paraaortic lymphadenectomy up to the left renal vein level, omentectomy, and multiple peritoneal biopsies, and hysterectomy except three fertility saving surgery.
  
  
  RESULTS
  The median age and median body mass index women were 49 years (range, 22-63) and 24.2m/kg(2) (range, 18.9-25.3), respectively. The median operating time was 230min (range, 155-370). The median numbers of harvested pelvic and paraaortic lymph nodes were 26 (range, 6-41) and 18 (range, 2-40), respectively. The median return of bowel activity was 28h (range, 21-79). Four of the women were upstaged from the initial presumed stage. There were two intraoperative complications, laceration of the inferior vena cava and cisterna chyli rupture. There was one postoperative complication, port-site metastasis. There was no conversion to laparotomic surgery. The median follow-up period was 33 months. Thirteen of the patients have no evidence of recurrences, however one patient died after 22 months after the surgery.
  
  
  CONCLUSIONS
  Laparoscopic restaging surgery, performed by a specialized laparoscopic oncologist with sufficient laparoscopic experience and a well-trained operating team, is both feasible and effective in the management of unexpected ovarian malignancies.
authors.affiliation: Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jaeman
authors.initials: J
authors.lastname: Bae
authors.affiliation: Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea. Electronic address: choiyjjy1@hanyang.ac.kr.
authors.forename: Joong Sub
authors.initials: JS
authors.lastname: Choi
authors.affiliation: Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Won Moo
authors.initials: WM
authors.lastname: Lee
authors.affiliation: Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: A Ra
authors.initials: AR
authors.lastname: Koh
authors.affiliation: Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Un Suk
authors.initials: US
authors.lastname: Jung
authors.affiliation: Department of Obstetrics and Gynecology, Kangwon National University Hospital, Chuncheon, Republic of Korea.
authors.forename: Jung Hwa
authors.initials: JH
authors.lastname: Ko
authors.affiliation: Department of Obstetrics and Gynecology, MizMedi Hospital, Eulji University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jung Hun
authors.initials: JH
authors.lastname: Lee
mesh_terms: D018195:Adenosarcoma / Q000473:pathology* / Q000601:surgery*; D000328:Adult; D001011:Aorta / Q000601:surgery; D001706:Biopsy / Q000009:adverse effects / Q000379:methods; D004407:Dysgerminoma / Q000473:pathology* / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods; D033162:Incidental Findings; D007422:Intestines / Q000503:physiopathology; D010535:Laparoscopy / Q000009:adverse effects; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000556:secondary / Q000601:surgery*; D009852:Omentum / Q000601:surgery; D061646:Operative Time; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery*; D010388:Pelvis / Q000601:surgery; D010533:Peritoneal Lavage / Q000009:adverse effects / Q000379:methods; D010537:Peritoneum / Q000473:pathology*; D020127:Recovery of Function; D012189:Retrospective Studies; D055815:Young Adult
keywords: Gynecology; Laparoscopy; Lymphadenectomy; Ovarian cancer; Restaging surgery