Role of staging laparoscopy to evaluate feasibility of performing optimal cytoreductive surgery in epithelial ovarian cancers

2016-11-13T23-03-50Z
Source: International Journal of Research in Medical Sciences
Sathyanarayanan M. Shivkumaran, Ganesh S. Mandakulutur, Keerthi R. Banavara.
Background: The main stay of treatment for epithelial ovarian cancers is surgical cytoreduction. CT scan and staging laparotomy are methods used to assess feasibility to carry out optimal cytoreduction. We evaluated the role of staging laparoscopy in assessing operability for optimal cytoreduction as well as avoidance of unnecessary laparotomies. Methods: Between September 2014-2016, 23 patients of epithelial ovarian cancer underwent staging laparoscopy as part of evaluation method to check feasibility to carry out optimal cytoreductive surgery. The findings were correlated with clinical findings as well as CT scan findings. The impact of laparoscopy to predict operability was studied as well as its use to avoid unnecessary laparotomies. Results: Laparoscopy could correctly evaluate the nature of abdominal mass in 91.3% patients. It picked up omental and peritoneal deposits in 87% and 95.7% patients respectively as compared to 60.9% and 39% picked up on CT scan. More importantly laparoscopy could diagnose mesenteric and small bowel deposits in 34.8% of patients which were never reported on CT scan. The overall impact was reduction in unnecessary laparotomies. Conclusions: Laparoscopic evaluation is a useful adjunct prior to performing a formal laparotomy in epithelial ovarian cancer cytoreductive surgery.


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