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Gynecol Oncol ; 129(2): 336-40, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23357611

RESUMO

OBJECTIVE: Analysis of perioperative outcomes and survival of patients with recurrent ovarian cancer undergoing secondary cytoreduction by robotics, laparoscopy, or laparotomy. METHODS: Retrospective analysis of 52 selected patients with recurrent ovarian cancer undergoing secondary cytoreduction by laparoscopy (9), laparotomy (33) or robotics (10) between January 2006 and December 2010. Comparison was made by a total of 21 factors including age, BMI, number of previous surgeries, tumor type and grade, number of procedures, and 15 types of procedures performed at secondary cytoreduction. RESULTS: For all patients, the mean operating time was 213.8 min, mean blood loss 657.4 ml; and mean hospital stay 7.5 days. Complete debulking was achieved in 75% of patients. Postoperative complications were noted in 36.5% of patients. Overall and progression-free survival at 3-years were 58.8% and 34.1%, respectively. Laparoscopy and robotics had reduced blood loss and hospital stay, while no differences were observed among the three groups for operating time, complications, complete debulking, and survival. CONCLUSION: Selected patients with recurrent ovarian cancer benefit from a laparoscopic or robotic secondary cytoreduction without compromising survival. Robotics and laparoscopy provide similar perioperative outcomes, and reduced blood loss and shorter hospital stay as compared to laparotomy. Laparotomy seems preferable for patients with widespread peritoneal implants, multiple sites of recurrence, and/or extensive adhesions.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/métodos , Laparoscopia , Laparotomia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Ovarianas/cirurgia , Robótica , Adulto , Idoso , Idoso de 80 Anos ou mais , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Duração da Cirurgia , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/patologia , Complicações Pós-Operatórias/epidemiologia , Reoperação , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento
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