Second-look operation for epithelial ovarian cancer: Laparoscopy or laparotomy? Journal Article
| Authors: | Abu-Rustum, N. R.; Barakat, R. R.; Siegel, P. L.; Venkatraman, E.; Curtin, J. P.; Hoskins, W. J. |
| Article Title: | Second-look operation for epithelial ovarian cancer: Laparoscopy or laparotomy? |
| Abstract: | Objectives: To compare the results, complications, and hospital charges associated with laparoscopy versus laparotomy in second-look operations for epithelial ovarian cancer. Methods: We conducted a retrospective chart review of 109 patients with invasive epithelial ovarian cancer who underwent a second-look operation between July 1,1992, and June 30, 1995. Results: Thirty-one patients (28.4%) underwent laparoscopy, 70 patients (64.2%) underwent laparotomy, and eight patients (7.3%) underwent both procedures at the same operation. The majority of patients (60.6%) presented with stage IIIC disease. Persistent ovarian cancer was found in 65 of 109 (59.6%) patients, including 17 of 31 (54.8%) evaluated by laparoscopy, 43 of 70 (61.4%) by laparotomy, and five of eight (62.5%) by both procedures. Significantly lower mean blood loss was noted in patients undergoing laparoscopy (27 mL) compared with laparotomy (208 mL) (P < .01). In addition, the mean operating time for laparoscopy (129 minutes) was significantly shorter than that for laparotomy (153 minutes) (P < .01), and mean hospital stay was shorter for patients undergoing laparoscopy (1.6 days) compared with laparotomy (6.8 days) (P < .01). All intraoperative and immediate postoperative complications were noted in patients who underwent laparotomy. There was no difference in day of surgery charges between the two procedures; however, total hospital charges were significantly lower for patients undergoing laparoscopy ($9448) compared with laparotomy ($17,969) (P < .01). With a median follow-up of 22.0 months, recurrence after negative second-look surgery was noted in four of 27 (14.8%) patients evaluated by laparotomy and two of 14 (14.3%) patients evaluated by laparoscopy. Conclusion: Laparoscopy may be an acceptable alternative to second-look laparotomy for interval evaluation of epithelial ovarian cancer. Second-look laparoscopy probably results in less morbidity, shorter operating time, shorter hos-pital stay, and lower total hospital charges. These results require confirmation in a randomized clinical trial. (Obstet Gynecol 1996;88:549-53). © 1996 Lippincott Williams & Wilkins, Inc. |
| Keywords: | adult; controlled study; human tissue; aged; surgical technique; major clinical study; clinical trial; cancer recurrence; cancer staging; follow up; laparoscopy; laparotomy; controlled clinical trial; ovary cancer; randomized controlled trial; practice guideline; hospitalization; operation duration; postoperative hemorrhage; second look surgery; hospital charge; human; female; priority journal; article |
| Journal Title: | Obstetrics and Gynecology |
| Volume: | 88 |
| Issue: | 4 Pt. 1 |
| ISSN: | 0029-7844 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 1996-10-01 |
| Start Page: | 549 |
| End Page: | 553 |
| Language: | English |
| PUBMED: | 8841216 |
| PROVIDER: | scopus |
| DOI: | 10.1016/0029-7844(96)00265-7 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 22 November 2017 -- Source: Scopus |
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382Seshan -
255Hoskins -
629Barakat -
112Curtin -
888Abu-Rustum
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