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Peritonectomy ovarian

Hee Seung Kim, Robert E Bristow, Suk-Joon Chang
OBJECTIVE: The majority of advanced ovarian cancer patients have peritoneal carcinomatosis involving from the pelvis to upper abdomen, which is a major obstacle to optimal cytoreduction. Since total parietal peritonectomy was introduced for treating peritoneal carcinomatosis from colorectal cancer [3], similar surgical techniques including pelvic peritonectomy have been applied in advanced ovarian cancer with peritoneal carcinomatosis [1], and these can increase the rate of complete cytoreduction up to 60% [2]...
October 13, 2016: Gynecologic Oncology
Roberto Tozzi, Zoe Traill, Riccardo Garruto Campanile, Federico Ferrari, Hooman Soleymani Majd, Joost Nieuwstad, Kieran Hardern, Kumar Gubbala
OBJECTIVE: To report the surgical technique of ovarian cancer resection at the porta hepatis (PH) and hepato-celiac lymph nodes (HCL). To assess surgical and survival outcomes. Define the accuracy of an integrated diagnostic pathway. METHODS: Patients with FIGO stage IIIC-IV ovarian cancer that underwent Visceral-Peritoneal Debulking (VPD). Data of patients with disease at the PH/HCL during VPD were extracted from our database. The CT scan findings were compared with the exploratory laparoscopy...
October 2016: Gynecologic Oncology
Brandon T Sawyer, Christopher J LaFargue, Robert E Bristow
OBJECTIVE: The completeness of primary cytoreductive surgery for Stage IV epithelial ovarian cancer is associated with greater progression free survival and overall survival Winter et al. (2008) [1]. Cytoreduction to no gross residual disease in patients with bulky upper abdominal disease presents significant surgical challenges, highlighting the importance of specialized and comprehensive surgical training in the treatment of advanced ovarian cancers Zivanovic et al. (2008) [2]. Extensive upper abdominal surgical procedures have shown to improve the ability to achieve cytoreduction to no gross residual disease Chi et al...
August 2016: Gynecologic Oncology
L B Xiang, Y X Tu, T C He, X Pei, X X Shen, W T Yang, X H Wu, H J Yang
OBJECTIVE: The aim of this study is to evaluate the safety and efficacy of partial pancreatectomy as part of primary cytoreductive surgery in advanced epithelial ovarian cancer (EOC). METHODS: A total of 8 patients were recruited in this study who underwent partial pancreatectomy during the primary cytoreductive surgeries for advanced EOC in Fudan University Shanghai Cancer Center from April 2009 to July 2015. Their clinicopathological characteristics, diameter of metastatic tumors, the scope of cytoreductive surgeries, residual diseases after cytoreductive surgeries, postoperative complications and survival situation were retrospective analyzed...
May 25, 2016: Zhonghua Fu Chan Ke za Zhi
B Moldovan, F Pescaru, D Pocreaţă, P Biriş, A Moldovan, M E Căpîlna
UNLABELLED: Summary BACKGROUND: This paper aims to present a "pattern" of oncosurgery solution in a case generally considered unrecoverable: intestinal occlusion in case of ovarian carcinoma and carcinomatosis. CASE REPORT: A 62-year-old female patient with ascites, carcinomatosis, unresectable pelvic tumour, and intestinal obstruction suffered a five-step oncosurgery "model": three surgical interventions overlapping chemotherapy administered via the systemic and intraperitoneal route: Step 1: colostomy and partial omentectomy; Step 2: five courses of systemic chemotherapy supported by granulocyte colony-stimulating factor; Step 3: radical surgery--total hysterectomy, bilateral adnexectomy, pelvic lymphadenectomy, omentectomy, appendectomy, pelvic peritonectomy, and hyperthermic intraperitoneal chemotherapy; Step 4: consolidation systemic chemotherapy consisting of three more similar cycles; Step 5: closure of the colostomy...
2016: European Journal of Gynaecological Oncology
Y S Kwon, K S Im, D I Choi
Large cell neuroendocrine carcinoma (LCNC) of the ovary is a rare tumor in gynecologic oncologic field. An 18-year-old woman presented with abdominal distention and a pelvic mass measuring ten cm in diameter, who previously underwent laparoscopic ovarian cystectomy due to large borderline mucinous ovarian neoplasm 18 months prior. A debulking operation was optimally performed, which included total abdominal hysterectomy with bilateral salpingo-oophorectomy, bilateral pelvic lymph node dissection, bilateral paraaortic lymph node dissection, omentectomy, optimal debulking of gastrohepatic mass and subdiaphragmatic mass, and pelvic peritonectomy...
2016: European Journal of Gynaecological Oncology
K Karadayi, C Yildiz, S Karakus, O Bozoklu Akkar, G Pakay Ugurlu, A Kurt, A Yanik
INTRODUCTION: The objective of this study was to assess the outcome of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) plus early postoperative intraperitoneal chemotherapy (EPIC) in patients with advanced gynecological malignancies. MATERIALS AND METHODS: A retrospective series of 51 patients with advanced gynecologic cancer, evaluated between May 2008 to February 2014. Peritoneal Cancer Index (PCI) and Completeness of Cytoreduction (CCR) score were used in the study group...
2016: European Journal of Gynaecological Oncology
Dogan Vatansever, Ali Emre Atici, Hamdullah Sozen, Onder Sakin
OBJECTIVE: The majority of ovarian cancer patients are initially diagnosed at an advanced-stage [1]. Upper abdominal bulky metastasis cephalad to the greater omentum reported to be present in 42% of patients [2]. Many complex surgical procedures such as splenectomy, pancreatectomy, mobilization and partial resection of liver, porta hepatis dissection, diaphragmatic peritonectomy and resection are frequently performed to achieve complete resection of metastatic disease [3]. Our aim in this surgical film is to show the resection of a left sided diaphragmatic implant located beneath the heart, with dissection from the pericardium after entrance to the pericardial cavity...
July 2016: Gynecologic Oncology
V Leung, N Huang, W Liauw, D L Morris
OBJECTIVE: Determine what portion of colorectal cancer (CRC) patients with peritoneal metastases (PM) undergoing peritonectomy would have been identified/treated if second-look surgery protocol existed for high-risk primary tumours. BACKGROUND: The prognosis of CRC PM greatly improves following peritonectomy/HIPEC. Survival remains dependent upon stage of PM and there is some knowledge of high-risk factors for its development. Subsequently, there is interest in routine second-look laparotomy to follow-up high-risk CRC patients so to 'prevent' PM...
June 2016: European Journal of Surgical Oncology
A Cistaro, M Cucinotta, L Cassalia, A Priola, S Priola, M Pappalardo, P Coppolino, M De Simone, N Quartuccio
AIM: Peritoneal carcinomatosis is a common evolution of neoplasms and the terminal stage of disease. A new therapeutic technique, based on the total surgical removal of peritoneal lesions (peritonectomy procedure - PP) combined with the intraperitoneal chemohyperthermia (IPCH), has been developed. Proper patient selection is mandatory for optimizing the results of treatment. The aim of this study was to investigate the role of [(18)F]fluoro-2-deoxy-d-glucose Positron Emission Tomography/Computed Tomography ((18)F-FDG PET/CT) in patients with peritoneal carcinosis selected to undergo PP and IPCH...
July 2016: Revista Española de Medicina Nuclear e Imagen Molecular
Valerio Gallotta, Fabio Ghezzi, Enrico Vizza, Anna Fagotti, Marcello Ceccaroni, Francesco Fanfani, Vito Chiantera, Alfredo Ercoli, Cristiano Rossitto, Carmine Conte, Stefano Uccella, Giacomo Corrado, Giovanni Scambia, Gabriella Ferrandina
STUDY OBJECTIVE: To investigate the feasibility and safety of laparoscopic cytoreduction in ovarian cancer patients with localized carcinomatosis or lymph node involvement. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Multi-institutional study performed in 6 referral gynecologic oncology units. PATIENTS: Between June 2005 and December 2014, preoperatively presumed early-stage ovarian cancer patients, who accidentally revealed localized carcinomatosis or lymph node involvement at laparoscopic evaluation or at postoperative pathological examination managed by the laparoscopic approach...
May 2016: Journal of Minimally Invasive Gynecology
Hooman Soleymani Majd, Federico Ferrari, Sanjiv Manek, Kumar Gubbala, Riccardo Garruto Campanile, Kieran Hardern, Roberto Tozzi
OBJECTIVE: To compare the surgical and histological outcomes of diaphragmatic peritonectomy vs. full thickness resection with pleurectomy during Visceral-Peritoneal Debulking. METHODS: Service evaluation protocol (Trust number 3265). All patients with stage IIIC-IV ovarian cancer who had diaphragmatic surgery between April 2009 and November 2013 were included. Clinical notes and histology reports were reviewed. Additional histology sections were undertaken. Patients were divided in Groups 1 (peritonectomy) and 2 (pleurectomy)...
March 2016: Gynecologic Oncology
Salvatore Gueli Alletti, Carolina Bottoni, Francesco Fanfani, Valerio Gallotta, Vito Chiantera, Barbara Costantini, Francesco Cosentino, Alfredo Ercoli, Giovanni Scambia, Anna Fagotti
BACKGROUND: Laparoscopy has acquired an increasing role in the management of ovarian cancer. Laparoscopic cytoreduction could represent a new frontier for selected patients after neoadjuvant chemotherapy (NACT). OBJECTIVE: We sought to assess feasibility and early complication rate of minimally invasive (MI) interval debulking surgery (IDS) in stage III-IV epithelial ovarian cancer (EOC) patients after NACT. STUDY DESIGN: This is a phase II multicentric study in advanced EOC cases with clinical complete response after NACT, according to Gynecologic Cancer Intergroup and Response Evaluation Criteria In Solid Tumors criteria...
April 2016: American Journal of Obstetrics and Gynecology
Nejat Ozgul, Derman Basaran, Gokhan Boyraz, M Coskun Salman
OBJECTIVE: Patients with advanced or recurrent ovarian cancer often have metastatic disease in the upper abdominal region, especially to the right hemidiaphragm, which requires diaphragmatic resection in order to achieve optimal cytoreduction. The aim of this surgical video is to demonstrate repair of a diaphragmatic injury and placement of tube thoracostomy during right upper quadrant peritonectomy in a patient with recurrent ovarian cancer. METHODS: This is the case of a 45-year-old woman presented with platinum sensitive recurrent ovarian cancer...
January 2016: Journal of Gynecologic Oncology
Sheng Yin, Rong Jiang, Pan Wang, Rongyu Zang
OBJECTIVES: This study was designed to validate the feasibility, effect on the new International Federation of Gynecology and Obstetrics (FIGO) staging, and surgical indications of transdiaphragmatic thoracic exploration (TDTE) without the use of thoracoscopy. METHODS: Patients with ovarian cancer who underwent TDTE after either diaphragm peritonectomy or full-thickness diaphragm resection between January 2009 and March 2014 were selected for our study. RESULTS: Twenty-two patients with a median age of 53 years and a median level of CA125 at 1134 U/mL before operation were included in our study...
October 2015: International Journal of Gynecological Cancer
Nayef Alzahrani, Jorgen S Ferguson, Sarah J Valle, Winston Liauw, Terence Chua, David L Morris
BACKGROUND: Peritoneal carcinomatosis (PC) results from the secondary spread of many intraabdominal tumour types, such as colorectal malignancy (colorectal cancer, CRC), disseminated peritoneal adenomucinosis (DPAM), appendiceal cancer, ovarian carcinoma, sarcoma or from the occurrence of primary peritoneal disease such as peritoneal mesothelioma. The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has seen improvements in survival in selected cases of these cancers...
July 14, 2015: ANZ Journal of Surgery
Paul H Sugarbaker
Despite the fact that cytoreductive surgery (CRS) and hyperthermic perioperative chemotherapy (HIPEC) is conceptually simplistic, optimal implementation of this combined treatment remains complex. Multiple patient-related variables, methodologic variables, and pharmacologic variables need to be considered in devising an optimal treatment strategy. Working through these variables considering the pathophysiology of peritoneal metastases and their possible treatments is more likely to provide guidance in terms of successful management than multiple randomized controlled trials...
May 2015: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Enrica Bentivegna, Henri Azaïs, Catherine Uzan, Alexandra Leary, Patricia Pautier, Clementine Gonthier, Catherine Genestie, Corinne Balleyguier, Catherine Lhomme, Pierre Duvillard, Philippe Morice, Sebastien Gouy
BACKGROUND: The goal, methods, and results of surgery for growing teratoma syndrome (GTS) in men after testicular cancer have been well described. The main surgical challenge relates to the need for vascular or thoracic procedures. But little is known about GTS in women, particularly regarding the optimal management of intraabdominal disease. This study aimed to evaluate the surgical management and outcomes (recurrences and fertility) for a large series of ovarian GTS. METHODS: This study retrospectively analyzed patients treated for an ovarian immature teratoma (IT) who subsequently experienced abdominal GTS requiring surgery...
December 2015: Annals of Surgical Oncology
Suk Joon Chang, Robert E Bristow
OBJECTIVE: The aim of this paper was to describe the operative details for en bloc removal of the adnexal tumor, uterus, pelvic peritoneum, and rectosigmoid colon with colorectal anastomosis in advanced epithelial ovarian cancer patients with widespread pelvic involvement. METHODS: The patient presented with good performance status and huge pelvic tumor extensively infiltrating into adjacent pelvic organs and obliterating the cul-de-sac. The patient underwent en bloc pelvic resection as primary cytoreductive surgery...
April 2015: Journal of Gynecologic Oncology
V Vukadinovic, J D Chiou, D L Morris
BACKGROUND: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) can be complicated by pulmonary emboli (PE). Patients are at high risk due to surgery, underlying malignancy, immobility and indwelling lines. OBJECTIVES: This paper aims to identify clinically significant signs and symptoms preceding acute PE in post CRS-HIPEC patients, assess the PE investigative approach in this population and the significance of PE on patient management...
May 2015: European Journal of Surgical Oncology
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