Introduction/Background Ovarian cancer is still the most lethal type of gynecological cancer because it does not show signs of the disease in the early period and there is no effective screening method. Cancer stage is an independent risk factor affecting the prognosis of the disease; and after primary staging surgery in the early stage and optimal cytoreductive surgery in the advanced stage, the disease-free and overall survival times of patients without visible residual tumor tissue increase significantly. Due to the superficial peritoneal spread of ovarian cancer, upper abdominal surgical procedures are often required to achieve surgical optimal cytoreduction. The aim of this study is to compare the mortality and morbidity rates of patients undergoing upper and lower abdominal cytoreductive surgery in our institution.

Methodology Patients who underwent cytoreductive surgery for ovarian malignancies from 2014 to 2020 were retrospectively identified from an institutional database. Upper abdominal cytoreduction was defined anatomically as debulking of disease proximal to the ligament of Treitz. Perioperative and postoperative outcomes were analyzed. (p<0.05 is referred as statistically significant)

Results A total of 148 operations were performed. All operations were performed by a single gynecologist oncologist. In operations with combined upper and lower abdominal cytoreduction versus only lower abdominal cytoreduction; diaphragm injury, blood transfusion, length of stay, atelectasis, pneumonia, effusion, wound infection and need for intensive care unit were found to be statistically significantly higher in patients undergoing upper abdominal surgery than in patients undergoing lower abdominal surgery.

Conclusion Upper abdominal surgery is a valid procedure for optimal cytoreduction in ovarian cancer. However, there is a greater risk of some complications occurring compared to lower abdominal surgery. Upper abdominal surgery in advanced ovarian cancer can be applied to patients with an acceptable complication profile when the possible survival advantage to be obtained is taken into account.