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Chapter-17 Peritonectomy in Ovarian Malignancy

BOOK TITLE: Ovarian Cancer: Comprehensive and Contemporary Management

Author
1. Biswas Manash
2. Kochar Sps
ISBN
9788184485394
DOI
10.5005/jp/books/10583_17
Edition
1/e
Publishing Year
2009
Pages
8
Author Affiliations
1. Armed Forces Medical College, Pune, manashbiswas@gmail.com
2. Armed Forces Medical College, Pune, spskochar@yahoo.com, Armed Forces Medical College, Pune -40, India, Army Hospital (Research and Referral), Delhi, India, Pune, Maharashtra, India, Pune
Chapter keywords

Abstract

Transcoelomic metastasis contributes substantially to the morbidity associated with ovarian cancer. The process of transcoelomic seeding could be a continuing adaptive behavior or a passive process facilitated by peritoneal current. This leads to malignant ascites and raised intra-peritoneal pressure with its all consequences. Specialized surgical procedures are practiced to remove the diseased peritoneum. For resection of diaphragmatic metastasis, pertinent knowledge of liver and diaphragmatic anatomy is important. Liver mobilization is essential for complete right diaphragmatic stripping. Splenectomy may be required to clear left diaphragmatic deposits. The technique of right ad left subphrenic stripping, cautions to be taken and complications are described in detail. Multiple peritonectomy procedures are necessary if one is aiming for maximum surgical cytoreduction. The pelvic peritonectomy is the most commonly performed procedure. Involvement of visceral peritoneum frequently requires resection of organs like colorectum, small intestine and stomach.

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