Open AccessA second thought on second look laparotomy
Author(s) -
BarAm Amiram,
Kovner Felix,
Lessing Joseph B.,
Inbar Moshe,
Chaitchik Samario,
Azem Foad,
Brenner Steven H.,
Peyser M. Reuben
Publication year - 1993
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.3109/00016349309021119
Subject(s) - laparotomy , medicine , surgery , stage (stratigraphy) , regimen , general surgery , disease , chemotherapy , ovarian carcinoma , ovarian cancer , cancer , paleontology , biology
Between 1982 and 1987, 43 patients with epithelial ovarian carcinoma, identified as International Federation of Gynaecology and Obstetrics Stages I‐IV, underwent second‐look laparotomy as a part of their treatment protocol. Twenty‐nine patients (67%) had no evidence of residual disease, five (11.6%) had residual disease 1 cm, and nine patients (20%) had residual disease 1 cm at re‐exploration. Persistent disease at the second operation was positively correlated with the initial clinical stage, and negatively correlated with the extent of the original cytoreductive surgery. Fifteen of 29 patients with negative findings (52%) developed recurrent disease within two years. All recurrences were limited to the abdominal cavity only. Three and five years survival, for the patients with negative findings, was 62% and 48% respectively. No documented benefit to the patients could be demonstrated by adopting second‐look laparotomy as a routine procedure in the management of patients with epithelial ovarian carcinoma. In view of our data, as well as that of others, such operations cannot be considered a valuable routine procedure. At this point, second‐look laparotomy may have a role in evaluating the efficacy of a post‐surgical new chemotherapy treatment regimen.