title: [Second-look in ovarian cancer: laparoscopy or laparotomy?].
abstract: 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.
authors.affiliation: Istituto di Ginecologia ed Ostetricia, Seconda Università degli Studi di Napoli. Alef2@wappi.com
authors.forename: A
authors.initials: A
authors.lastname: Russo
authors.forename: G
authors.initials: G
authors.lastname: Cirelli
authors.forename: E
authors.initials: E
authors.lastname: Cassese
authors.forename: D
authors.initials: D
authors.lastname: Delli Ponti
authors.forename: R
authors.initials: R
authors.lastname: Sgambato
authors.forename: F
authors.initials: F
authors.lastname: Cecere
authors.forename: R
authors.initials: R
authors.lastname: Zarcone
mesh_terms: D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D010051:Ovarian Neoplasms / Q000601:surgery*; D024162:Second-Look Surgery
vernacular_title: Second-look per cancro dell'ovaio: laparoscopia o laparotomia?