The controversial 'second-look' laparotomy.

Abstract

To determine optimal indications for and clinical assessment of the significance of relaparotomy, the data of 304 women with malignant ovarian tumours (of epithelial origin, predominantly, 72%) who had undergone a 'second-look' operation were analysed. 'Second-look' relaparotomies were performed 10-22 months after the initial operation, on the following clinical indications: 1) clinical remission after initial combined treatment (surgery + chemotherapy) in cases where malignant cells are found at systematically performed cytological examinations of ??? or lavage from peritoneal surfaces of the Douglas cul-de-sac plus high levels of CA 125 in blood serum (8 patients with stages I and II, FIGO classification); 2) remission after adequate combined treatment and following 6-10 cycles of polychemotherapy, in order to decide whether to abandon or continue with treatment (13 patients with stages III and IV); 3) clinical remission following initial operation which was voluminously non-radical (117 patients); 4) suspicion of tumour recurrence after adequate combined treatment (114 patients); 5) no suspicion of cancer recurrence, though with ventral hernia or other pathology requiring relaparotomy (22 patients). Complications arising at the 'second-look' operation or during the postoperative period were observed in 29 of the 304 patients (9.5%), giving a postoperative mortality of 0.9%. According to experience, the positive significance of 'second-look' operations to optimize treatment of patients with malignant ovarian tumours is obvious.

• Authors: Bokhman YaV, V L Vinokurov, E I Gulo
• Journal: Acta obstetricia et gynecologica Scandinavica. Supplement (Acta Obstet Gynecol Scand Suppl) Vol. 155 Pg. 79-83 ( 1992) ISSN: 0300-8835 [Print] Denmark
• PMID: 1502895 (Publication Type: Comparative Study, Journal Article)

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Chemotherapy, Adjuvant
• Cystadenocarcinoma (drug therapy, mortality, surgery)
• Female
• Follow-Up Studies
• Humans
• Laparotomy
• Middle Aged
• Ovarian Neoplasms (drug therapy, mortality, surgery)
• Postoperative Complications (epidemiology)
• Reoperation