Loop electrosurgical excision procedure for intensified cytoreduction of ovarian cancer

The objective was to evaluate the loop electrosurgical excision procedure (LEEP) for intensified cytoreduction of ovarian cancer. Twenty consecutive women with residual epithelial ovarian cancer following maximum cytoreduction by standard surgical techniques were treated with LEEP-intensified cytoreduction. LEEP was employed to resect metastases involving intestines (18 patients), diaphragm (3 patients), liver (6 patients), spleen (3 patients), and peritoneal surface (18 patients). Median LEEP time was 9 min (range 3-27 min). Blood loss secondary to LEEP was minimal with no patient experiencing bleeding > 20 ml. Following LEEP-intensified cytoreduction, 17 of 20 patients (85%) had no gross residual disease. Seventeen of 18 patients (94%) had all intestinal metastases resected. All superficial liver (6 patients) and splenic metastases (3 patients) were completely resected. Peritoneal metastases were completely resected in all 18 patients. No patient experienced a complication directly related to LEEP. LEEP can be performed rapidly, with minimum blood loss, and results in intensified cytoreduction with minimal morbidity.