Introduction/Background Standard approach for the initial treatment of advanced ovarian cancer (AOC) is surgical removal of all visible implants of the disease through a large midline laparotomy. Although laparoscopy has been shown to be safe and effective in early stage EOC, few surgeons have adopted this approach for patients with advanced disease. We want to present our fist experience of laparoscopic complete primary cytoreduction in AOC.
Methodology Having an extensive experience in performing laparoscopic radical operations for early OC and interval debulking for AOC, since 2018 we’d started to perform primary cytoreduction (PC) in AOC. Till now 5 PC were done. Average age 50,8 (44–54) years. Average PCI 14 (4–29) and Fagotty score 3 (2–8). In all cases total hysterectomy with omentectomy, peritonectomy, pelvic and paraaortal lymphadenectomy were done. Other procedures were: diaphragmatic stripping (2), colorectal resection with primary anastomosis (4), resection of small bowel (1), splenectomy (1), hepatic resection (2).
Results Complete cytoreduction (CC0) with no residual tumor was achieved in all cases. Average operative time was 285 (150–370) minutes. Estimated blood loss - 175 (50–470) ml. Mean length of hospital stay - 14,4 (4–46) days. Mean number of lymph nodes harvested 23,2 (13–31). Postoperative complications grade IIIB–IV occurred in 1 patient: intraoperative heart failure and anastomotic leak with relaparoscopy. No patients died.
Conclusion Laparoscopic primary cytoreduction with multivisceral resection in AOC is technically feasible in experienced hands and can be offered to carefully selected patients with AOC. Potential postoperative advantages of laparoscopic approach are faster recovery and relatively low morbidity.
Disclosure Nothing to disclose.
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