title: Outcomes after laparoscopic techniques in major gastrointestinal surgery.
abstract: OBJECTIVE
  Despite the benefits of minimally invasive surgery, its use in oncological resections has been adopted slowly. We highlight the differences in short-term and long-term outcomes between laparoscopic and open surgery for colorectal and gastric cancer. Furthermore, we review the relevance of postoperative fast-track methodologies in improving surgical outcomes after laparoscopic resections.
  
  
  RESULTS
  Numerous randomized controlled trials demonstrate equivalent short-term and long-term outcomes (including oncologic outcomes) after laparoscopic colon resection. Though recent retrospective studies demonstrate its safety in rectal and gastric cancer resection, large-scale randomized controlled trials demonstrating its safe use in this setting are pending. Additionally, evidence to support the use of fast-track postoperative care modalities in gastrointestinal surgery continues to increase. These fast-track protocols should be implemented in conjunction with laparoscopic techniques to enhance patient recovery, reduce postoperative ileus and length of hospital stay.
  
  
  CONCLUSIONS
  Laparoscopic techniques are safe and at least equivalent to open surgery for colon cancer resections. Studies evaluating the role of laparoscopic techniques in rectal and gastric cancer resection are ongoing. Additionally, fast-track postoperative care methodologies improve recovery after surgery and should be applied to the clinical setting to enhance outcomes after laparoscopic surgery.
authors.affiliation: Division of General Surgery, Department of Surgery, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Bharat
authors.initials: B
authors.lastname: Sharma
authors.forename: Nancy
authors.initials: N
authors.lastname: Baxter
authors.forename: Teodor
authors.initials: T
authors.lastname: Grantcharov
mesh_terms: D015179:Colorectal Neoplasms / Q000601:surgery*; D005773:Gastroscopy / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000706:statistics & numerical data*; D007902:Length of Stay; D019060:Minimally Invasive Surgical Procedures; D009864:Ontario; D011183:Postoperative Complications; D013274:Stomach Neoplasms / Q000601:surgery*; D000267:Tissue Adhesions; D016896:Treatment Outcome