[Laparoscopic surgery for colonic cancer: present status and evaluation].
It has been 15 years since laparoscopic surgery was first performed in colonic cancer. An inquiry-based analysis by the Japan Society of Endoscopic Surgery (JSES) in 2003 showed a steady increase in the number of laparoscopic colonic resections for cancer. This report also indicates that advanced cancer candidates exceeded early-stage patients in 2003. From the technical point of view, pure laparoscopic access and a medial dissection approach rather than hand-assisted laparoscopic surgery (HALS) and a lateral dissection approach is more likely to be selected as a standard procedure. In 2004, the Endoscopic Surgical Skill Qualification System was proposed by the JSES to promote safer laparoscopic surgery in Japan. For colonic qualification, a thorough videotape of colonic cancer resection is to be evaluated so that not only laparoscopic surgical skill but also oncologic handling is taken into account. In clinical research, based on the results of a multicenter, randomized, controlled study of open vs. laparoscopic-assisted colectomy in the USA and Europe, a Japanese trial has also now started to determine the optimum quality control of surgical skill. The results of this study arre expected to lead to less deviation in the level of surgical skill.
Okajima
Masazumi
M
Department of Endoscopic Surgery and Surgical Science, Hiroshima University Graduate School of Biomedical Sciences.
Ikeda
Satoshi
S
Egi
Hiroyuki
H
Yoshimitsu
Masanori
M
Asahara
Toshimasa
T
D002983:Clinical Competence / Q000592:standards; D003110:Colonic Neoplasms / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D020535:Video-Assisted Surgery