During surgical treatment, surgeons carefully remove the ovary with the tumor and, if possible, all metastases outside it, if they are present. Specialists also identify the stage (prevalence in the body) and determine the structure of this tumor.
Surgical treatment is performed for oncologically suspected ovarian tumors based on the results of comprehensive preoperative examinations.
The scenario that occurs most often is surgical treatment of patients with advanced ovarian cancer, but not all tumors primarily originated on the ovaries, in 10-15% it formed in other organs and spread to the ovaries a second time. In this case, the treatment will be very different. Therefore, we pay great attention to the preoperative examination of patients, performing breast MRI and gastro- and colonoscopy. Then a treatment plan is drawn up individually for each patient.
The second type of surgery for ovarian cancer is cytoreduction. It is performed either as a continuation of laparoscopy (if the tumor is recognized as operable), or delayed as a separate interval operation after several preparatory cycles of chemotherapy. During such an abdominal operation, the ovaries affected by the tumor, uterus, omentum and all metastases in the abdominal cavity and pelvis are removed, wherever they may be.
Before surgery for ovarian cancer, it is important to conduct a comprehensive examination. A gynecologist may suspect ovarian cancer during a preventive gynecological examination or pelvic ultrasound. If a woman has suspicious dense formations, she is prescribed additional tests: a blood test for cancer markers (most often for ovarian cancer these are CA125 and HE4), examinations of the abdominal cavity and pelvis using computed tomography (CT), positron emission computed tomography (PET / CT), magnetic resonance imaging (MRI) with contrast.
If a patient with a suspected ovarian tumor has concomitant diseases, or is an elderly woman, she will be examined by other specialists (pulmonologists, cardiologists, internists, etc., if necessary) before surgical treatment. They help prepare a patient with ovarian cancer for surgery and thereby reduce the risk of complications during and after surgical treatment. So, if a patient with ovarian cancer has diabetes, it is important to adjust sugar levels before surgical treatment, with hypertension it is important to normalize blood pressure. A few days before the surgical treatment, the patient comes for a consultation with an anesthesiologist after the examinations.
The day before the surgical treatment, the patient cleanses the intestines at home according to a special protocol. We ask patients to remove all jewelry or piercings, not to drink or eat 8 hours before surgery, not to use makeup or nail polish, and to take a shower before surgery.
For laparoscopic surgery, the size of the tumor is more than 10 cm. It cannot be removed safely, as it may rupture. In this case, abdominal operations are performed immediately.
If the malignant neoplasm has spread strongly beyond the ovaries and has affected vital organs or has spread massively over the surfaces of the peritoneum, then complete removal of the tumor by surgery is not recommended and contraindicated. Surgeons can determine the operability of each case at the stage of such a special laparoscopic diagnosis. If the patient cannot have an open operation now, then at the EMC, surgeons take the biopsy material laparoscopically without cutting the abdominal cavity. In this case, you can start chemotherapy treatment the very next day. It helps to reduce the size of the tumor, which in the future will allow a complete operation to remove the malignant neoplasm (optimal or complete cytoreduction).
Acute strokes, heart attacks, and the presence of an acute infection in the active phase also serve as contraindications for surgical treatment to remove ovarian cancer.
