Feasibility and rationale of a novel approach in advanced ovarian cancer surgery: Bat- shaped en-bloc total peritonectomy and total hysterectomy salpingo-oophorectomy with or without rectosigmoid resection (Sarta-Bat approach)

To evaluate the feasibility of bat-shaped en-bloc total peritonectomy and total hysterectomy-salpingo-oophorectomy with or without rectosigmoid resection as a novel approach in advanced ovarian cancer surgery. Advanced ovarian cancer patients with widespread peritoneal implants requiring total perit...

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Bibliographic Details
Published in:Gynecologic oncology 2021-04, Vol.161 (1), p.97-103
Main Authors: Khatib, Ghanim, Seyfettinoglu, Sevtap, Guzel, Ahmet Baris, Gulec, Umran Kucukgoz, Unlugenc, Hakkı, Vardar, Mehmet Ali
Format: Article
Language:English
Subjects:
Advanced ovarian cancer
Cytoreductive surgery
En-bloc pelvic resection
Surgical approach
Total peritonectomy
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Summary:To evaluate the feasibility of bat-shaped en-bloc total peritonectomy and total hysterectomy-salpingo-oophorectomy with or without rectosigmoid resection as a novel approach in advanced ovarian cancer surgery. Advanced ovarian cancer patients with widespread peritoneal implants requiring total peritonectomy were the subject of the study. Thirteen cases were operated with Sarta-Bat approach between February 2019 and July 2020. Patients' clinical and surgical data were collected and statistically analyzed. Median age of the patients was 52 (40–65). Histopathology of the tumors were high-grade serous carcinoma in 12 (92.3%) and carcinosarcoma in one (7.7%) cases and all of them originated from the ovary. Eight (61.5%), two (15.4%) and three (23.1%) patients were stage 3c, 4a, and 4b, respectively. Upper abdomen was involved in all cases. Nine cases underwent primary cytoreductive and four cases interval cytoreductive surgery. Sarta-Bat approach was performed as en-bloc total peritonectomy, total hysterectomy bilateral salpingo-oophorectomy with rectosigmoid resection in three and without rectosigmoid resection in 10 cases. Final surgery resulted in complete cytoreduction (no macroscopic residual) in all cases, with acceptable grade 2–3 morbidity rates. Sarta-Bat approach is a feasible and convenient technique for cytoreductive surgery of advanced ovarian cancer with disseminated peritoneal metastases. •Sarta-Bat approach is a feasible and expedient concept for cytoreductive surgery in advanced ovarian cancer.•Sarta-Bat approach is a practical, effective, and timesaving technique in patients with disseminated peritoneal metastases.•Sarta-Bat approach have the potential to maximize the complete cytoreduction (R0) results with acceptable morbidity rates.
ISSN:0090-8258
1095-6859
DOI:10.1016/j.ygyno.2020.11.011