Laparoscopic colorectal resection with curative intent. Own results and review of the literature.
OBJECTIVE
Laparoscopic surgery is without a doubt one of the most important innovations in the field of surgery in the last 15 years. Since the 1st laparoscopic colorectal resection in 1991, this modality has spread like wildfire. Nevertheless, laparoscopic surgery in the field of oncology is still regarded as controversial. On the basis of our current knowledge, the present study considers the advantages and disadvantages of laparoscopic surgery performed with a curative intent - with emphasis on oncological radicalness and long-term outcome - and evaluates them against our own results.


METHODS
In principle, the extent of the resection, compliance with margins of clearance, radicalness of lymphadenectomy and the avoidance of intra-abdominal tumour dissemination (for example, no touch technique) must be applied equally to the laparoscopic modality, too.


RESULTS
At present there would not appear to be any restrictions vis-à-vis open surgery in any of the oncological parameters. Nor do currently available long-term results provide any evidence that laparoscopic colorectal surgery is in any way inferior.


CONCLUSIONS
Colorectal oncological interventions with curative intent are still recommended to be done only in controlled studies. A final assessment will not be possible until the results of ongoing prospective randomized multicentre studies become available.
Scheidbach
H
H
Department of Surgery, Otto-von-Guericke University, Magdeburg, Germany. scheidbach@t-online.de
Lippert
H
H
Köckerling
F
F
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009366:Neoplasm Seeding; D011446:Prospective Studies; D012449:Safety; D016019:Survival Analysis; D016896:Treatment Outcome