Ovarian Tumor: Challenges During Surgery

Ovarian tumors like most other gynecological conditions like endometriosis, leiomyoma, PID, etc. are known to throw surprises on the operating table. Before posting a patient with an ovarian tumor for surgery, one has to keep in mind that the tumor could be benign, borderline, or malignant. Borderline ovarian tumors are not premalignant tumors, but a separate category of ovarian tumors with a unique behavior of their own. They have an excellent prognosis even when advanced. A successful surgery for ovarian tumors depends a lot on a thorough preoperative workup, and in many cases the benign, borderline, or the malignant nature of the tumor is confirmed only after receiving the frozen section report. The surgery that needs to be performed, in many cases depends on the frozen section report. In contrast, the surgery to be performed for a case of endometriosis, leiomyoma, PID, etc. is straightforward and depends on the patient’s age and fertility issues. This may not be the case in cases of ovarian tumors—the patient may be a young nulligravida with a suspected benign tumor, but the frozen section may reveal an aggressive malignancy. The important points to be kept in mind while operating on ovarian tumors are - Any intraoperative spillage of an early stage malignancy results in upstaging of the disease, and this can be very significant in the overall prognosis of young patients who have a long life ahead. - A complete staging is essential. If proper staging is missed, then it has a bearing on the subsequent management and overall prognosis of the disease. - Availability of frozen section during surgery is very important since it has a bearing on what surgery needs to be performed. Another important point that has to be kept in mind before planning to operate on a patient with ovarian tumor is that the disease load can be huge with extensive involvement of abdominal organs, but the ovarian tumor itself could be relatively small. Conversely, a patient with abdominal pain and distention could have metastatic ovarian tumor with the primary malignancy not being overtly symptomatic. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

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