Feasibility of laparoscopic diaphragmatic peritonectomy during Visceral-Peritoneal Debulking (VPD) in patients with stage IIIC-IV ovarian cancer.
Diaphragmatic Peritonectomy
Laparoscopy
Ovarian Cancer
Journal
Journal of gynecologic oncology
ISSN: 2005-0399
Titre abrégé: J Gynecol Oncol
Pays: Korea (South)
ID NLM: 101483150
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
30
03
2020
revised:
24
04
2020
accepted:
08
05
2020
entrez:
19
8
2020
pubmed:
19
8
2020
medline:
2
9
2021
Statut:
ppublish
Résumé
To describe the surgical technique and evaluate the safety, feasibility and efficacy of laparoscopic diaphragmatic peritonectomy during Visceral-Peritoneal Debulking (VPD) in patients with stage IIIC-IV ovarian cancer (OC). This report is part of a Service Evaluation Protocol (Trust number 3267) on laparoscopy in patients with OC following neo-adjuvant chemotherapy. Between April 2015 and November 2017, all patients underwent to exploratory laparoscopy and a selected court was offered laparoscopic VPD. Laparoscopic diaphragmatic surgery was considered if there was no full thickness involvement. Primary endpoints of this part of the study were the safety, feasibility and efficacy of laparoscopic diaphragmatic peritonectomy. We report the surgical technique and outcomes. Ninety-six patients underwent diaphragmatic surgery during the study period. Fifty patients (52.1%) had intra-operative exclusion criteria and/or full thickness diaphragmatic resection, 46 (47.9%) had peritonectomy and were included in the study. Laparoscopic diaphragmatic peritonectomy was performed in 21 patients (45.4%, group 1), while in 25 patients (54.6%, group 2) laparotomy was necessary. Extent of disease and complexity of surgery were similar. Reasons for conversions were disease coalescing the liver to the diaphragm preventing safe mobilization (22 patients) and accidental pleural opening (3 patients). Overall, intra- and post-operative morbidity was lower in group 1 and pulmonary specific morbidity was very low. Diaphragmatic peritonectomy can be safely accomplished by laparoscopy in almost half of the patients with OC whose disease is limited to the diaphragmatic peritoneum.
Identifiants
pubmed: 32808498
pii: 31.e71
doi: 10.3802/jgo.2020.31.e71
pmc: PMC7440979
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e71Informations de copyright
Copyright © 2020. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.
Déclaration de conflit d'intérêts
No potential conflict of interest relevant to this article was reported.
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