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Between the years 1984 and 1988, 43 patients with bulky advanced stage epithelial ovarian carcinoma underwent en bloc pelvic resection with excision of the rectosigmoid colon as part of their primary cytoreductive surgery. Optimal cytoreduction was accomplished in over 70% of cases, and all women had complete debulking of their pelvic tumor. Primary anastomosis of the bowel was feasible in all cases and only two covering colostomies were performed. There were no postoperative leaks or fistulas. The postoperative morbidity was reflected by a mean postoperative hospital stay of 16 days. Our results suggest that this technique facilitates optimal cytoreduction of bulky pelvic tumor with an acceptably low morbidity in woman with advanced ovarian carcinoma.