PubMed1986
The most important step in the treatment of epithelial ovarian carcinoma is radical surgery which should be as radical as possible, since this can exercise a decisive influence on the effectiveness of subsequent chemotherapy or radiotherapy. During 1981-1984 98 patients with an ovarian carcinoma were operated upon. 82 of these patients had epithelial tumours that will be discussed in the article. The mean age was 59.9 years. 88% of the patients were additionally at risk by one or several risk factors. Surgical approach was standardised: longitudinal incision, hysterectomy, adenectomy, resection of omentum and, if necessary, maximum possible removal of the peritoneum of the pelvis. In 28 cases additional surgery became necessary at the intestine. 77% of the patients (n = 63) were in the advanced stages FIGO III and IV. In 50 patients the operation lasted for up to 4 hours, in 24 up to 6 hours and in 8 for more than 6 hours. Intraoperative complications occurred in 37% (twice lesion of the ureter, in 5 cases intestinal lesion, in 23 cases anaesthesiological problems due to preexisting risks). In stages I and II reduction of tumour size below 2 cm was achieved in 100% of the cases, in stage III in 87.5%, in stage IV in 45%. Two patients died postoperatively. The postoperative complication rate was 48%. Almost 30% of these were represented by cardiopulmonary disturbances. Although the percentage appears high, most of the problems were well manageable, so that the patients could be transferred to follow-up therapy within 2-3 weeks. For type of follow-up therapy, tumour response.(ABSTRACT TRUNCATED AT 250 WORDS)