CARBON-DIOXIDE LASER VAPORIZATION OF INTESTINAL METASTASES OF EPITHELIAL OVARIAN-CANCER

Purpose To determine the efficacy and morbidity of carbon dioxide laser vaporization of intestinal metastases of epithelial ovarian cancer. Patients and methods Following maximum surgical cytoreduction, 20 patients were treated with laser vaporization of serosal and mesenteric metastases with a carbon dioxide hand-held laser at a median wattage of 25 watts using a super-pulse mode. The maximum diameter of intestinal metastases ranged from 1 mm to 2 em and the number ranged from 1 to >100 implants. These patients were compared with 20 matched controls. Results Median laser time was 7 min and no patient experienced bleeding >15 ml. Eighteen patients (90%) had no gross residual disease following laser vaporization compared to five (25%) of the controls (P = 0.0001). Nineteen patients (95%) had no gross intestinal residual disease following laser vaporization compared to eight (40%) of the controls (P = 0.01). There was no difference in the incidence of postoperative ileus, wound infection or febrile morbidity between the groups. No patient in either group developed bowel obstruction, perforation, fistula, peritonitis or abscess. Conclusion Carbon dioxide laser vaporization of intestinal metastases of epithelial ovarian cancer represents intensive cytoreduction which results in superior debulking and does not appear to increase postoperative morbidity.