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Abstract
Introduction/Background Surgery of the mesentery has been reported in other surgical disciplines along with resection of the dependent bowel segment. In patients with ovarian cancer, this technique would imply extensive bowel resection, leading to severe malnutrition and impacting on the timely provision of chemotherapy. Therefore, a technique that spares the bowel and selectively removes the disease on the meso is highly desirable.
Objective The aim is to describe the surgical technique, assess its feasibility, efficacy, and safety in performing peritonectomy and/or resection of mesentery (P-Rme) during Visceral-Peritoneal Debulking (VPD) in patients with stage IIIC-IV ovarian cancer (OC).
Methodology We investigate the safety and feasibility of P-Rme during the period from April 2009 to December 2022.
Six hundred eighty-seven patients with FIGO stage IIIC-IV ovarian cancer underwent VPD, and among them, 129 patients (18.7%) had extensive disease on the mesentery and underwent P-Rme.
Results In all patients P-Rme was successfully completed. P-me was performed in 82 patients and R-me in 47, and both procedures in 23 patients. Complete resection (CR) was achieved in all 129 patients, demonstrating an efficacy of 100%. Intra-operative complications occurred in 25 patients, resulting in an overall morbidity rate of 19.3%. Five patients out of 129 experienced intra-operative small bowel loop surgical devascularization, treated with small bowel resection and anastomosis. The procedure specific morbidity was 3.8%. One post-operative complication was related to P-Rme.
Conclusion Overall, almost 20% of the VPD patients needed P-Rme to obtain a CR. P-Rme was a safe and effective step during VPD. The rate of CR in the study group was 100% achieved thanks to the addition of the P-Rme. No procedure specific post-operative complications occurred but 3.8% of the patients had unplanned additional surgery related to these procedures.
Disclosures None.
