Minimally Invasive Surgery for Resection of Diaphragm Metastases in Ovarian Cancer

Javier F. Magrina, Tatiana Cuesta Guardiola, Paul Magtibay, Heidi E. Kosiorek

Research output: Contribution to journalArticle

Abstract

Study Objective: To estimate pulmonary complications and diaphragm recurrence after resection of diaphragm metastases by minimally invasive surgery (MIS) for epithelial ovarian cancer (EOC). Design: Retrospective analysis (Canadian Task Force classification III). Setting: Mayo Clinic in Scottsdale, Arizona, from January 1, 2004, through January 31, 2014. Patients: Selected cohort of 29 patients. Interventions: Diaphragm resection by MIS (robotics, 21; laparoscopy, 8) for EOC. Measurements and Main Results: To assess for pulmonary complications most likely due to diaphragm resection, patients were excluded if they had preoperative pleural effusions or pulmonary disease or had undergone additional upper abdominal procedures. Mean patient age was 58.7 years (standard deviation, 14.9) and mean BMI was 24.2 kg/m2 (standard deviation, 3.4). The mean size of diaphragm metastases was 56.7 mm (range, 2–145). Full-thickness resection was performed in 6 patients; 23 had peritoneal resection. Complete resection was achieved in all patients with no conversions to laparotomy. Two patients (6.9%) had pulmonary complications (pleural effusion). Six patients (20.7%) had diaphragm recurrence; 10 patients (34.5%) had recurrence at other abdominal sites. Conclusion: Resection of diaphragm metastases by MIS appears to be feasible and safe for selected patients, with similar recurrence as other abdominal sites.

Original languageEnglish (US)
JournalJournal of Minimally Invasive Gynecology
DOIs
StateAccepted/In press - Jan 1 2019

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Minimally Invasive Surgical Procedures
Diaphragm
Ovarian Neoplasms
Neoplasm Metastasis
Recurrence
Pleural Effusion
Lung
Pleural Diseases
Robotics
Advisory Committees
Laparoscopy
Laparotomy
Lung Diseases

Keywords

  • Diaphragm resection
  • Laparoscopy
  • Ovarian cancer
  • Robotics

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Minimally Invasive Surgery for Resection of Diaphragm Metastases in Ovarian Cancer. / Magrina, Javier F.; Guardiola, Tatiana Cuesta; Magtibay, Paul; Kosiorek, Heidi E.

In: Journal of Minimally Invasive Gynecology, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Study Objective: To estimate pulmonary complications and diaphragm recurrence after resection of diaphragm metastases by minimally invasive surgery (MIS) for epithelial ovarian cancer (EOC). Design: Retrospective analysis (Canadian Task Force classification III). Setting: Mayo Clinic in Scottsdale, Arizona, from January 1, 2004, through January 31, 2014. Patients: Selected cohort of 29 patients. Interventions: Diaphragm resection by MIS (robotics, 21; laparoscopy, 8) for EOC. Measurements and Main Results: To assess for pulmonary complications most likely due to diaphragm resection, patients were excluded if they had preoperative pleural effusions or pulmonary disease or had undergone additional upper abdominal procedures. Mean patient age was 58.7 years (standard deviation, 14.9) and mean BMI was 24.2 kg/m2 (standard deviation, 3.4). The mean size of diaphragm metastases was 56.7 mm (range, 2–145). Full-thickness resection was performed in 6 patients; 23 had peritoneal resection. Complete resection was achieved in all patients with no conversions to laparotomy. Two patients (6.9{\%}) had pulmonary complications (pleural effusion). Six patients (20.7{\%}) had diaphragm recurrence; 10 patients (34.5{\%}) had recurrence at other abdominal sites. Conclusion: Resection of diaphragm metastases by MIS appears to be feasible and safe for selected patients, with similar recurrence as other abdominal sites.",
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