Feasibility and efficacy of laparoscopic management of ovarian cancer

The aim of this study was to evaluate the feasibility and efficacy of laparoscopically-assisted staging surgery for ovarian cancer.

Twenty four patients were evaluated. Among them, nineteen underwent initial laparoscopic staging surgery and five patients who were incompletely staged by other institutions underwent complete restaging surgery. The procedure included pelvic lymphadenectomy, paraaortic lymphadenectomy, multiple biopsies, washing cytology, infracolic omentectomy, and appendectomy. Laparoscopically assisted vaginal hysterectomy and bilateral salpingo-oophorectomy were performed on all patients except one. Parameters such as tumor diameter, operating time, estimated blood loss, length of hospital stay, number of harvested lymph nodes, intraoperative and postoperative complications, and recurrence were evaluated.

The patients' mean age was 52.8 +/- 11.3 years and the mean parity was 2.5 +/- 1.6. The mean diameter of the tumors was 8.4 +/- 3.3 cm, the mean operating time was 253.7 +/- 65.7 minutes, and the mean blood loss was 567.0 +/- 170.9 mL. The mean postoperative hospital stay was 10.6 +/- 4.0 days. The mean number of harvested pelvic lymph nodes was 22.5 +/- 8.9 and the mean number of harvested paraaortic lymph nodes was 11.0 +/- 5.8. None of the operations were switched to laparotomy. There were no major intraoperative complications, however, port site metastasis developed postoperatively in one patient.

Comprehensive laparoscopically-assisted staging surgery, performed by a specialized laparoscopic oncologist with sufficient laparoscopic experience and a well-trained operating team, is both feasible and effective in treating ovarian cancers.