[Cytoreductive procedures in advanced primary ovarian carcinoma]

Female patient, 68, hospitalized due to vaginal bleeding, anaemia and defecation disorder. We have done examinations as follows: clinical and laboratory exams, which confirmed severe anaemia. Explorative curretage of uterus--PH findings: malignant tissue. Rectoscopy: extraluminal compression at lo cm from the anal verge. Irigography: spasticity and extraluminal compression to proximal third of rectum and distal sigmoid colon. Ultrasound of abdomen: solid lobular formation 10 x 7 cm in diameter, on the left side of the urinary bladder, surrounded by thin layer of ascites. Ultrasound of liver: without signs of malignant disease. CT-scan of pelvis and abdomen: metastatic lymph nodes, up to 40 mm in diameter, alongside abdominal aorta; solid-lobular tumor, 10 x 7 cm, on the left side of urinary bladder, which fills the central portion of pelvic cavum. Secundary malignant deposits on the pelvic parietal peritoneum with minimal quantity of ascites (peritoneal carcinomatosis). Intraoperative findings confirmed malignant deposits on the right colon serosa, so we performed right hemicolectomy with ileo-colo anastomosis, omentectomy, hysterectomy, bilateral adnexectomy, low anterior resection of the rectum, peritonectomy of pelvis and reconstruction of digestive tubus by colo-rectal anastomosis with circular stapler ILS 33. Duration of operation was 6:45 hours, blood loss was 1100 ml. Intraoperatively was intraperitonealy applicated Adriamycin. One month after the operation, systemic chemotherapy consisting of Endoxan and Karboblastin was administered, for the duration of 6 months, once monthly. Twelve months after the operation NMR showed normal findings, patient was without evidents of recurrent disease.