title: [Laparoscopic surgery for colorectal cancer].
abstract: BACKGROUND
  It has been possible to perform colorectal operations for cancer with a laparoscopic approach for several years, but most operations are still performed by laparotomy. A systematic overview of randomized studies that compare the two techniques is presented.
  
  
  METHODS
  Pubmed and Embase were systematically searched for relevant randomized clinical trials.
  
  
  RESULTS
  11 randomized clinical trials were identified. Most trials showed that laparoscopic surgery for colorectal cancer was associated with significantly longer operating time (8/11), significantly less intraoperative blood loss (5/7) and a shorter hospital stay (8/10) than open surgery. There were significantly fewer complications after laparoscopic surgery in four of 11 studies. None of the studies showed any significant differences in mortality (6/6). Survival after colon cancer surgery was reported in five studies. In one case, improved disease-free survival after laparoscopic surgery was found whereas the other four showed no significant differences. Two of these studies also included rectal cancer but did not report separate data for these patients. One study that included 28 patients found no difference in cancer-related survival after laparoscopic and open surgery for rectal cancer.
  
  
  CONCLUSIONS
  Laparoscopic surgery is an acceptable alternative to open surgery in patients with colon cancer. The procedure can be offered to patients in hospitals where experienced laparoscopic surgeons are available. In rectal cancer surgery, evidence is scarce and results from large randomized trials have to be awaited.
authors.affiliation: Kirurgisk avdeling, Sykehuset Namsos, 7800 Namsos. esther.kuhry@helse-nordtrondelag.no
authors.forename: Esther
authors.initials: E
authors.lastname: Kuhry
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Saetnan
authors.forename: Hallvard
authors.initials: H
authors.lastname: Graeslie
authors.forename: Robin
authors.initials: R
authors.lastname: Gaupset
mesh_terms: D003110:Colonic Neoplasms / Q000401:mortality / Q000601:surgery; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D007902:Length of Stay; D011183:Postoperative Complications / Q000401:mortality; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery; D012811:Sigmoid Neoplasms / Q000401:mortality / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome