Extraperitoneal Approach During Peritonectomy in the Right Upper Quadrant for Peritoneal Metastases from Ovarian Malignancies.

AIM:To present the extraperitoneal approach for the removal of peritoneal metastases in the right upper abdomen in patients with ovarian cancer and to evaluate safety and potential advantages with comparison with the traditional approach.PATIENTS AND METHODS:Detailed description of the right upper quadrant peritonectomy as extraperitoneal approach. Procedure-specific short-term complications were retrospectively analyzed in a cohort of patients.RESULTS:Sixty-four patients were included. Full-thickness diaphragmatic resection was performed in 17% of primary cases, and in 44% of the patients with recurrent ovarian carcinoma. The rate of complete cytoreduction (CC-0) was 70%. The most common postoperative complication was pleural effusion (32%).CONCLUSION:The extraperitoneal approach for peritonectomy of the right upper quadrant in patients with ovarian cancer is feasible, with improved access to the right subdiaphragmatic area. This enables a high rate of complete cytoreduction, and simplified and safe surgical dissection in an uncontaminated area under secured vascular structures. The early postoperative outcomes are comparable to those of the traditional transperitoneal approach.