[Clinical evaluation of second-look operations in colorectal cancer]

The second look operation (SLO) for early detection of recurrent tumor is indicated rarely because of the advance in diagnostic techniques such as imaging radiology, tumor marker serology and colonofiberscopy. The SLO was performed in 21 out of 362 curative cases of colorectal cancer resected in our department; 13 for re-elevation of plasma CEA level (Group 1), 6 for unclear symptoms or signs (Group 2) and 2 for postchemotherapy or postirradiation (Group 3). Liver metastases were found in four cases in group 1 and two in group 2. Nothing was found in three cases in group 1 and two in group 2. In group 3 the radical operation was carried out in all cases following SLO with good survival results. In group 1 and 2 the excisional rate of liver metastases in 57%, its salvage rate 75%, and the excisional rate of the lymph nodes is 50%, with a salvage rate of 100%. The SLO today is indicated for cases of asymptomatic re-elevation of CEA titer, for cases of undeterminable signs or for cases of postchemotherapeutic or postirradiation improvement.