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Second look for ovarian cancer: laparoscopy or Laparotomy? A prospective comparative study
K B Clough1, J M Ladonne, C Nos
1Department of Surgery, Department of Pathology, Institut Curie, 26 rue d'Ulm, Paris, 75005, France.
Gynecologic Oncology
|March 4, 1999
Summary
Laparoscopic second look for ovarian cancer is less reliable than laparotomy due to adhesions. This technique has a lower rate of complete intraperitoneal investigation and higher complication risk.
Area of Science:
- Gynecologic Oncology
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Ovarian cancer treatment often involves second-look surgery to assess residual disease.
- Laparoscopy offers potential benefits over laparotomy, but its efficacy in this setting requires evaluation.
Purpose of the Study:
- To assess the feasibility, reliability, and complications of laparoscopic second look in ovarian cancer patients.
- To compare laparoscopic second look with laparotomy in the same patients.
Main Methods:
- Twenty ovarian cancer patients in complete remission underwent both laparoscopic and open laparotomy second-look procedures.
- Procedures followed identical checklists including intraperitoneal inspection, cytology, and biopsies.
- Each patient served as their own control for both techniques.
Main Results:
- Laparoscopy showed 100% positive predictive value but 86% negative predictive value for residual disease.
- Complete intraperitoneal investigation rates were 95% for laparotomy versus 41% for laparoscopy.
- Laparoscopy required conversion to laparotomy in 5.3% of cases due to complications.
Conclusions:
- Laparoscopic second look is less reliable than laparotomy for ovarian cancer.
- Postoperative adhesions significantly hinder complete and safe laparoscopic assessment.