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322 The use of curettage in the management of diaphragmatic involvement in patients with primary advanced-stage ovarian or peritoneal cancer
  1. R Puente and
  2. E Schneider
  1. Austral University, Obstetrics and Gynecology Institute. Gynecologic Oncology Section, Valdivia, Chile


Objectives To know the usefulness of diaphragm curettage to remove all metastasis in patients with primary advanced-stage ovarian or peritoneal cancer, with diaphragmatic involvement.

Methods In 16 consecutive patients with advanced primary epithelial ovarian or peritoneal cancer with diaphragmatic involvement we performed diaphragm curettage with a big sharp curette (Aesculap N 16) as a part of cytoreductive surgery, after liver mobilization. We used narrow curettes in areas with difficult access. The procedure had limited bleeding controlled by coagulation and hot compress.

Results In all 16 patients, the curettage removed completely the tumor implants, in one or both diaphragms, without residual disease. In the postoperative time, 3 patients had basal pleural effusion, reasorbed spontaneously.

Conclusions Diaphragmatic curettage is a safe and effective procedure to treat the diaphragm involvement in cytoreductive surgery of ovarian or peritoneal carcinoma, decreasing the morbidity of the surgery.

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