PARCELAR GASTRIC RESECTION IN ASSOCIATION WITH BOWEL RESECTIONS AS PART OF DEBULKING SURGERY FOR ADVANCED STAGE OVARIAN CANCER – A CASE REPORT

Nicolae Bacalbasa, ,Department Of Surgery, Ramnicu Sarat County Hospital, Buzau, Romania ,Doctoral School, “Titu Maiorescu“ University, Bucharest, Romania ,Irina Balescu,Adnan Al Aloul,Department Of Surgery, Ponderas Academic Hospital, Bucharest, Romania

doi:10.37897/rmj.2021.2.28

Abstract

Ovarian cancer represents one of the most aggressive gynecological malignancies affecting women worldwide, associated with significant rates of cancer related death within the first years after the initial diagnostic. The poor survival rates are usually explained by the presence of disseminated lesions even from the beginning. In such situations, the digestive tube is one of the most commonly involved territory, therefore necessitating extended resections in order to achieve complete cytoreduction. The aim of this paper is to report the case of a 53 year old patient who was diagnosed with peritoneal carcinomatosis from ovarian cancer, presenting multiple levels of digestive tract involvement due to the presence of disseminated tumoral masses. Therefore the patients was submitted to multiple digestive resections represented by parcelar gastrectomy, segmental ileal resection and subtotal colectomy. In order to minimize the risks of developing severe postoperative complications – due to the relatively high number of anastomoses – the continuity of the digestive tract was established by a terminal ileostomy, considering that creation of a ileorectal anastomosis would be too dangerous in the context of multiple digestive resections. The postoperative evolution was simple, the patient being further submitted to adjuvant treatment.

Highlights

Ovarian cancer still represents the leading cause of mortality among all gynecological cancers affecting women worldwide with high capacity of spread via multiple pathways
Initially it has been considered that peritoneal carcinomatosis is the sign of disseminated disease, more recent studies came to demonstrate that such cases should be rather considered to have an abdominal confined disease and should be treated by the means of cytoreductive surgery
One of the most commonly involved area is represented by the gastrointestinal tract, tumoral nodules of peritoneal carcinomatosis being able to develop at the level of any serosa [4]

Summary

INTRODUCTION

Ovarian cancer still represents the leading cause of mortality among all gynecological cancers affecting women worldwide with high capacity of spread via multiple pathways. Most often patients are diagnosed when systemic dissemination is already present, extended resections being needed in order to achieve complete cytoreduction [1,2,3]. Initially it has been considered that peritoneal carcinomatosis is the sign of disseminated disease, more recent studies came to demonstrate that such cases should be rather considered to have an abdominal confined disease and should be treated by the means of cytoreductive surgery. One of the most commonly involved area is represented by the gastrointestinal tract, tumoral nodules of peritoneal carcinomatosis being able to develop at the level of any serosa [4]. Ovarian cancer that necessitated extended gastrointestinal resections in order to achieve no residual disease

CASE PRESENTATION

Findings

CONCLUSIONS