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

Purpose To determine the efficacy and morbidity of carbon dioxide lase r vaporization of intestinal metastases of epithelial ovarian cancer. Patients and methods Following maximum surgical cytoreduction, 20 pati ents were treated with laser vaporization of serosal and mesenteric me tastases 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 >1 00 implants. These patients were compared with 20 matched controls. Re sults Median laser time was 7 min and no patient experienced bleeding >15 ml. Eighteen patients (90%) had no gross residual disease followin g laser vaporization compared to five (25%) of the controls (P = 0.000 1). Nineteen patients (95%) had no gross intestinal residual disease f ollowing laser vaporization compared to eight (40%) of the controls (P = 0.01). There was no difference in the incidence of postoperative il eus, wound infection or febrile morbidity between the groups. No patie nt in either group developed bowel obstruction, perforation, fistula, peritonitis or abscess. Conclusion Carbon dioxide laser vaporization o f intestinal metastases of epithelial ovarian cancer represents intens ive cytoreduction which results in superior debulking and does not app ear to increase postoperative morbidity.