Description
After a negative second-look laparoscopy, does a further, third-look laparoscopy find more peritoneal metastases in patients treated for pT4 colon cancer? In the COLOPEC 2 randomised trial across 19 hospitals in the Netherlands, 305 patients with a negative second-look laparoscopy were assigned to routine follow-up alone or with an additional laparoscopy at 18 months. At 20 months, peritoneal metastases had been diagnosed in 10 of 154 patients (6.5%) in the control group and 19 of 151 (12.6%) in the third-look group; the trial did not demonstrate superiority, and some uncertainty remains about whether diagnostic laparoscopy offers benefit beyond routine follow-up. Across 435 procedures, three patients had a grade 3 complication, and there were no deaths within 30 days. The authors conclude that these findings do not support routine third-look laparoscopy in this setting.
Read the full research article by Hamm and colleagues in The Lancet Surgery & Anaesthesiology here:
https://www.thelancet.com/journals/lansur/article/PIIS3117-7778(26)00006-0/fulltext?dgcid=youtube_video_vabs_lansur_tlsurg
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