Surgical treatment of ovarian cancer
Mariusz Bidziński, Anna Dańska-Bidzińska
The paper presents current algorithms of surgical treatment of patients with ovarian cancer. At early clinical stages (FIGO stage I and II), the basic principle of surgical treatment is radical excision of malignant lesions within the pelvis and meticulous search for metastatic foci of tumour within the mid-abdomen and epigastrium. Therefore, mandatory procedures include omentectomy, multiple sampling of peritoneum (including diaphragmatic lining) and periaortal lymph nodes. In late-stage disease (FIGO stages III and IV), the main task is to remove all metastatic foci, both within the abdominal cavity and retroperitoneal space. In late-stage cases, surgery requires great expertise of both surgical, anesthetic and physiotherapy teams. Required are also precise surgical instruments, including argon bipolar coagulation, a reliable diathermy unit and a kit of self-retaining retractors. Extensive cytoreductive procedures are burdened by an elevated complication rate, therefore in selected cases preoperative (neoadjuvant) chemotherapy is used.