[Second-look in ovarian cancer: laparoscopy or laparotomy?].
BACKGROUND
The aim of the present study was to compare the laparoscopic second-look with laparotomic second-look as regards the consistency of diagnosis of residual tumoral disease after first step treatment in patients affected by ovarian cancer, and to evaluate the feasibility of the laparoscopic second-look.


METHODS
Twenty-one patients affected by ovarian cancer underwent laparoscopic second-look followed by laparotomic second-look. Six months after the first surgical intervention all the patients showed no contraindications to laparoscopic second-look. All the surgeries were performed with the same procedure: after the introduction of the trocars the lysis of adherences was carried out, the whole abdominal cavity was explored, 18 abdominal-pelvic sites were examined, direct biopsies were performed and samples for the cyto- and histological analysis were obtained.


RESULTS
Positive predictive value for laparoscopy was 100% (6 out of 6 cases), while negative predictive value was 84% (2 false negative cases out of 12). The complete abdominal-pelvic examination was possible in 95% of cases with laparotomy while in 41% of cases with laparoscopy, because of post-operative severe adherences.


CONCLUSIONS
Laparoscopic second-look has a good consistency as regards the diagnosis of residual tumoral disease, but its feasibility is lower than laparotomy owing to the presence of severe adherences and the high risk of intra- and post-operative compliances.
Russo
A
A
Istituto di Ginecologia ed Ostetricia, Seconda Università degli Studi di Napoli. Alef2@wappi.com
Cirelli
G
G
Cassese
E
E
Delli Ponti
D
D
Sgambato
R
R
Cecere
F
F
Zarcone
R
R
D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D010051:Ovarian Neoplasms / Q000601:surgery*; D024162:Second-Look Surgery
Second-look per cancro dell'ovaio: laparoscopia o laparotomia?