Introduction/Background*Standard treatment for advanced ovarian cancer patients should be primary cytoreduction following platinum-based chemotherapy. The aim of surgical effort should be the complete removal of all macroscopic disease. Surgery of upper abdomen is often required to obtain optimal cytoreduction. Our objective was to evaluate perioperative features, postoperative complications of patients who underwent diaphragmatic stripping or diaphragmatic resection for advanced ovarian cancer.

Methodology From June 2018 to April 2021, 138 patients underwent cytoreductive surgery for advanced ovarian cancer at San Raffaele Hospital. Forty-one cases were selected, among them 29 underwent diaphragmatic stripping and 12 underwent diaphragmatic full-thickness resection during primary cytoreduction surgery (PCS) or interval debulking surgery (IDS). All surgical procedures were performed by use of bipolar scissors and blunted resection. Data collected included patients’ age, all perioperative details and pathological findings, International Federation of Gynecology and Obstetrics stage.

Result(s)*Median age was 60 (range 32-79) years. Median hospital stays were 7 (range 4-26) days. Thirty-five patients (85%) obtained optimal cytoreduction with absence of macroscopic disease. Mean loss of blood was 391ml (±172). Thirty-four (83%) patients underwent PDS and 7 (17%) underwent IDS. Postoperative pleural effusion rate was 14,6% without any differences between stripping or diaphragmatic resection (p=0,423). One case of pneumothorax was reported in the stripping group.

Conclusion*Diaphragmatic surgery at the time of primary cytoreductive surgery or IDS for advanced ovarian cancer may contribute to the achievement of complete cytoreduction with low perioperative complication rate. Risk of postoperative pleural effusion could be limited by utilization of bipolar scissors and blunted resection to perform surgical procedures.