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    Interventional procedure overview of maximal effort cytoreductive surgery for advanced ovarian cancer

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    Existing assessments of this procedure

    A consensus statement titled 'Governance models to support patient safety when undergoing maximal effort cytoreductive surgery for advanced ovarian/fallopian tube/primary peritoneal cancer – a joint statement of ACPGBI, ASGBI, AUGIS and BGCS' was published in 2022 (Maxwell-Armstrong 2022). This statement sets out a framework for joint working for gynaecological oncologists and colorectal and UGI surgeons.

    The European Society of Gynaecological Oncology published guidelines on ovarian cancer surgery in 2017 (Querleu 2017). It states: 'Midline laparotomy is required to manage stage III to IV ovarian cancers (expert agreement). Complete resection of all visible diseases is the goal of surgical management. Voluntary use of incomplete surgery (upfront or interval) is discouraged (grade A). Criteria against abdominal debulking are the following (expert agreement):

    • Diffuse deep infiltration of the root of small bowel mesentery

    • Diffuse carcinomatosis of the small bowel involving such large parts that resection would lead to short bowel syndrome(remaining bowel G 1.5 m)

    • Diffuse involvement/deep infiltration of the stomach/duodenum (limited excision is possible) and head or middle part of the pancreas (tail of the pancreas can be resected)

    • Involvement of truncus coeliacus, hepatic arteries, and left gastric artery (celiac nodes can be resected).'