Second look laparotomy--its role in the management of ovarian carcinoma.

Almost 30 years after its introduction into the management of ovarian carcinoma, second-look laparotomy remains controversial. Although its supporters agree on its indications, there is a considerable number of conflicting reports on the actual benefits of the procedure. Diagnostic inaccuracy, invasiveness and expense are some of the reasons raised by opponents against its routine performance and their recommendations range from limited selective application to total avoidance. The role of second-look laparotomy is reviewed, with particular reference to developing countries where scarcity of resources must always be balanced against the need to provide the best care possible to the individual cancer patient. A management schedule for ovarian carcinoma, including second-look laparotomy, appropriate under these circumstances is given.