medical notes

Apr 17th, 2015
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Debulking in Ovarian CancerAshraf Fawzy NabhanAssistant Prof. of Obstetrics & GynecologyAin Shams University, Cairo, EgyptIntroduction Surgery is an essential in treatingovarian cancer. Diagnosis, staging, and therapy areperformed at the time of laparotomy Debulking (cytoreduction) is thesurgical approach for ovariancarcinomaPatterns of spread Direct extension Exfoliation of clonogenic cells Lymphatic spreadRationale of debulking Cell kinetics Log Cell-kill hypothesis Gompertizian Growth hypothesis Cell mutations Goldie-Coldman hypothesisSurgical stagingVertical incisionPeritoneal washingsTAH plus BSOPelvic & abdominal biopsiesPelvic and paraaortic lymphadenectomy appendectomyPrimary Debulking Early ovarian cancer the procedure is the operative staging ofthe cancer Advanced ovarian cancer In addition to the procedure of theoperative staging, some aggressivesurgical procedures might be consideredPrimary Debulking Aggressive surgical procedures Multiple or extensive bowel resection Rectosigmoid resection Resection of ureteral/bladder segment Diaphragm stripping Resection of liver, spleen, kidney,diaphragmPrimary Debulking optimal primary debulking (residualdisease <1 cm) is an independentprognostic factor Even in patients with unresectableliver metastasis, optimal debulking ofextrahepatic disease is associated witha

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