Association of diaphragmatic surgery as part of cytoreductive effort in advanced stage ovarian cancer

Abstract

Background/Aim: Diaphragmatic surgery in advanced-stage ovarian cancer has been considered since long time to increase the rates of postoperative complications. However, improvement of surgical techniques and perioperative management of these patients has lead in the last decade to a safe association of such procedures as part of debulking process. The aim of the current paper was to report our experience regarding the role of diaphragmatic resections as part of debulking surgery for advanced stage ovarian cancer. Materials and Methods: Between 2014 and 2016 diaphragmatic surgery was performed in 22 cases with advanced stage ovarian cancer. Results: Diaphragmatic surgery consisted of diaphragmatic peritoneal resection in 10 cases, full thickness diaphragmatic resections in four cases and coagulation of peritoneal nodules in eight cases. In all but two cases debulking surgery to no residual disease was achieved. Other upper abdominal resections consisted of splenectomy – in four cases, liver resections – in three cases, glissonian capsule resections – in eight cases, distal pancreatectomy – in one case and partial gastrectomies in two cases. The postoperative outcomes were similar irrespective of type of diaphragmatic surgical procedure. Conclusion: Diaphragmatic surgery is a crucial procedure which can be safely associated as part of debulking surgery for advanced stage ovarian cancer.