Total pelvic peritonectomy for ovarian cancer with extensive peritoneal carcinomatosis in pelvic cavity.
Gynecol Oncol
; 154(3): 651-652, 2019 09.
Article
em En
| MEDLINE
| ID: mdl-31326138
ABSTRACT
BACKGROUND:
Ovarian cancer is characteristic of superficial implantation and peritoneal carcinomatosis. Hudson introduced a novel technique 50â¯years ago, which removed the entire Douglas pouch as a false capsule of the tumor (Hudson, 1968 [1]). Angeles et al. standardized the procedure in 10 steps in a previous publication (Angeles et al., 2019 [2]). We made small modifications of the Hudson procedure in this video. Ovarian cancer is characteristic of superficial implantation and peritoneal carcinomatosis. Hudson introduced a novel technique 50â¯years ago, which removed the entire Douglas pouch as a false capsule of the tumor (Hudson, 1968 [1]). Angeles et al. standardized the procedure in 10 steps in a previous publication (Angeles et al., 2019 [2]). We made small modifications of the Hudson procedure in this video.METHODS:
The key points of the procedure were summarized as follows. Firstly, dissecting off the pelvic parietal peritoneum very superficially. Secondly, the round ligament, infundibulo-pelvic ligament, medial umbilical ligament, and umbilical artery are divided and ligated in the extraperitoneal space. Thirdly, the bladder is mobilized caudally and the vesico-vaginal space is exposed after completely dissecting off the vesical peritoneum. Fourthly, the ureter is isolated and mobilized laterally. Then, uterine vessels and parametria are divided and ligated, which is followed by colpotomy to access the recto-vaginal septum. By retracting the total specimen cranially, the Douglas pouch is dissected retrogradely according to Hudson procedure. Lastly, the peritoneum of the mesorectum and mesosigmoid is shaved at the pelvic brim. Therefore, using this method, almost all the pelvic visceral peritoneum was dissected (). In addition, we didn't intentionally expose the anatomical spaces (pre-vesical, para-vesical, para-rectal, and pre-sacral) completely, which was effective and time-saving.RESULTS:
Complete removal of the disseminated tumors in both parietal and visceral peritoneum was achieved by the method introduced in our video.CONCLUSION:
Our method, modified from Hudson procedure, is effective for complete cytoreduction in selected ovarian cancer patients with extensive peritoneal carcinomatosis sparing rectosigmoid resection.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Ovarianas
/
Exenteração Pélvica
/
Neoplasias Peritoneais
Limite:
Female
/
Humans
Idioma:
En
Revista:
Gynecol Oncol
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
China