Ultraradical debulking of epithelial ovarian cancer with the ultrasonic surgical aspirator: A prospective randomized trial

Abstract

OBJECTIVE: Our purpose was to evaluate the effectiveness, benefits, and potential side effects of the use of the cavitational ultrasonic surgical aspirator for cytoreduction of advanced ovarian cancer. STUDY DESIGN: Forty patients with stage IIC to IV ovarian carcinoma were randomized to undergo ultraradical cytoreductive surgery with (group 1, 20 patients) or without (group 2, 20 patients) the use of the CUSA 200 cavitational ultrasonic surgical aspirator (Valleylab, Boulder, Colo.). Preoperative and postoperative information and follow-up data were collected prospectively and compared between both groups. RESULTS: The amount of residual tumor after debulking surgery, the duration of the operation, and the rate of perioperative complications were comparable in both study groups. The amount of perioperative blood loss was significantly lower (1450 ml vs 1650 ml, p = 0.02) in group 1. These patients had less morbidity ( p < 0.05), and could be discharged from the hospital significantly sooner (14 days vs 16 days, p = 0.031). CA 125 levels 1 and 2 months after surgery were significantly lower in the group with cavitational ultrasonic surgical aspirator ( p < 0.01 and p < 0.01, respectively), suggesting more successful cytoreduction. However, this is not reflected in a better disease-free or overall survival. CONCLUSION: Cavitational ultrasonic surgical aspirator - assisted cytoreductive surgery of advanced ovarian carcinoma is more effective in eradicating disease, reduces morbidity, and is cost beneficial. (A M J O BSTET G YNECOL 1996;174:943-50.)