title: Laparoscopic vs. open approach for colorectal cancer: evolution over time of minimal invasive surgery.
abstract: BACKGROUND
  In the late '80s the successes of the laparoscopic surgery for gallbladder disease laid the foundations on the modern use of this surgical technique in a variety of diseases. In the last 20 years, laparoscopic colorectal surgery had become a popular treatment option for colorectal cancer patients.
  
  
  CONCLUSIONS
  Many studies emphasized on the benefits stating the significant advantages of the laparoscopic approach compared with the open surgery of reduced blood loss, early return of intestinal motility, lower overall morbidity, and shorter duration of hospital stay, leading to a general agreement on laparoscopic surgery as an alternative to conventional open surgery for colon cancer. The reduced hospital stay may also decrease the cost of the laparoscopic surgery for colorectal cancer, despite th higher operative spending compared with open surgery. The average reduction in total direct costs is difficult to define due to the increasing cost over time, making challenging the comparisons between studies conducted during a time range of more than 10 years. However, despite the theoretical advantages of laparoscopic surgery, it is still not considered the standard treatment for colorectal cancer patients due to technical limitations or the characteristics of the patients that may affect short and long term outcomes.
  
  
  CONCLUSIONS
  The laparoscopic approach to colectomy is slowly gaining acceptance for the management of colorectal pathology. Laparoscopic surgery for colon cancer demonstrates better short-term outcome, oncologic safety, and equivalent long-term outcome of open surgery. For rectal cancer, laparoscopic technique can be more complex depending on the tumor location. The advantages of minimally invasive surgery may translate better care quality for oncological patients and lead to increased cost saving through the introduction of active enhanced recovery programs which are likely cost-effective from the perspective of the hospital health-care providers.
authors.forename: Antonio
authors.initials: A
authors.lastname: Biondi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Grosso
authors.forename: Antonio
authors.initials: A
authors.lastname: Mistretta
authors.forename: Stefano
authors.initials: S
authors.lastname: Marventano
authors.forename: Chiara
authors.initials: C
authors.lastname: Toscano
authors.forename: Filippo
authors.initials: F
authors.lastname: Drago
authors.forename: Santi
authors.initials: S
authors.lastname: Gangi
authors.forename: Francesco
authors.initials: F
authors.lastname: Basile
mesh_terms: D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D019060:Minimally Invasive Surgical Procedures / Q000379:methods / Q000639:trends; D013997:Time Factors