Second-look laparoscopy prior to proposed second-look laparotomy.

A prospective study was carried out to evaluate the use of second-look laparoscopy in patients in complete clinical remission after prolonged chemotherapy for advanced ovarian adenocarcinoma. Twenty-two patients with FIGO stages IIB, III, and IV ovarian adenocarcinoma underwent second-look laparoscopy after a median of 23 months of therapy. Eight (36.3%) patients had documented evidence of persistent ovarian cancer and were thus spared second-look laparotomy. Moreover, in 4 patients (18.1%), malignant cells in cytologic washings were the only laparoscopic evidence of persistent ovarian cancer. The absence of visible tumor and malignant cells in cytologic washings allows for the use of second-look laparotomy while the patient is under 1 anesthesia; the presence of tumor or malignant cells in cytologic washings spares the patient second-look laparotomy at that time.