PALLIATIVE SURGERY FOR OVARIAN CANCER
The majority of patients with advanced-stage ovarian cancer will recur and ultimately succumb to their disease. Interventions such as secondary cytoreduction, salvage chemotherapy, and clinical trials may prolong life but are almost never curative. The surgeon caring for women with ovarian cancer is likewise faced with difficult decisions regarding potentially palliative procedures that may improve quality of life but also carry the potential to cause significant morbidity and mortality. This chapter outlines the diagnostic evaluation and surgical management of patients with symptomatic advanced-stage ovarian cancer. At laparotomy, the site of obstruction is the small bowel in 44%–61% of cases, the large bowel in 18%–33%, and a combination of small and large bowel in 9%–22%. The staple of diagnostic evaluation of suspected small bowel obstruction is the plain film of the abdomen with flat and upright views.
