Laparoscopic surgery for colorectal cancer.
Traditionally open surgical resection has been recommended for colorectal tumours, but recently, laparoscopic surgery has gained popularity. This review summarizes the published data on laparoscopic colorectal cancer surgery with emphasis on recently published trials. For colon cancer laparoscopic resection appears to be associated with the same outcome as open surgery. However, whilst short-term outcome was better in the laparoscopic group in most of the randomized trials, when comparing laparoscopic with fast-track open surgery, no differences could be demonstrated in a randomized control trial. For rectal cancer the data are less clear. It seems that it may be feasible to resect at least small rectal cancers laparoscopically. Clearly the role of the laparoscopic technique needs to be better defined in rectal cancer. It has been well documented that short- and long-term outcome of colorectal cancer surgery depends on the quality and experience of the team treating the patient. Therefore, the major future challenge in laparoscopic colorectal cancer surgery will be to provide and structure adequate training and introduce quality control measures.
Kienle
P
P
Department of Surgery, University of Heidelberg, Heidelberg, Germany. peter.kienle@med.uni-heidelberg.be
Weitz
J
J
Koch
M
M
Büchler
M W
MW
D003082:Colectomy / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome