Das laparosopisch »anoperierte« Ovarialkarzinom. Vorgehen und Prognose

Translated title of the contribution: The laparoscopic »biopsied« ovarian carcinoma. Management and prognosis

M. Pölcher, M. Braun, W. Kuhn

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Unexpected ovarian malignancy after laparoscopic surgery accounts for approximately 0,4-3%. It is the most important clinical problem related to unexpected cancer found during gynaecologic surgery. To avoid inadequate operative therapy of ovarian cancer meticulous preoperative assessment of an adnexal mass should be considered. The combination of sonography and Doppler sonography achieves high and reproducible diagnostic accuracy in preoperative malignancy status assessment of adnexal tumors. Using sonography and Doppler sonography the best discrimination was achieved by displaying the presence of »solid area« and the vascular distribution »central vascularization«. Patients with clinical suspected ovarian cancer should undergo laparotomy, patients with non-suspicious masses should be operated by laparoscopy with identical safety standards. The intraoperative cyst rupture seems to worsen the prognosis of patients independent from the surgical procedure. The carbon dioxid pneumoperitoneum used in laparoscopic surgery has not yet been proved to stimulate growth of ovarian tumor cells nor to have an effect on the prognostic value of an increased rate of intraabdominal metastases. Patients with unexpected ovarian cancer found during laparoscopic surgery should be considered a »logistic emergency« and therefore be treated by all means of adequate oncologic guidelines within 8 days after primary diagnosis: Retrospective data indicate the prognostic relevant occurence of peritoneal metastases after 8 days. An uncommon indication for laparoscopy of ovarian cancer is the histologic verification in »high-risk« poly-morbid patients and in patients before planed neoadjuvant chemotherapy.

Translated title of the contributionThe laparoscopic »biopsied« ovarian carcinoma. Management and prognosis
Original languageGerman
Pages (from-to)479-488
Number of pages10
JournalGynakologische Praxis
Volume28
Issue number3
StatePublished - Sep 2004
Externally publishedYes

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