Second Look Proactive Surgery for Colon Cancer with Peritoneal Carcinomatosis

Abstract

Second look surgery in patients with colorectal cancer has always been, a controversial subject. The surgical literature suggests benefit in a re operation, where a limited extent of cancer is discovered and then resected with negative surgical margins. This paper seeks to identify the clinical factors that predispose to the recurrence of a primary colorectal cancer and the benefit of a second look surgery. It represents the attitude of a new treatment strategy in cases that the patient develops peritoneal metastasis at the initial operation and after an adjuvant treatment with systemic chemotherapy. We also discuss the intra-operative criteria, especially after the initial operation, in order to propose a therapeutic algorithm in the management of advanced colorectal disease.