Current Status of Laparoscopic Surgery in Colorectal Cancer

Abstract

Laparoscopic colorectal procedures offer several benefits postoperatively, including reduction of pain, minimal impairment of pulmonary and gastrointestinal function, and improved reconvalescence. At present, laparoscopic resections for colorectal cancer are discussed controversially due to oncologic radicality, potential tumor dissemination, and the fundamental problem of port-site metastases. Oncologic standards of open surgery for colorectal cancer are not compromised by the laparoscopic technique. Short-term results of both retrospective and prospective trials comparing open with laparoscopic surgery for colorectal cancer showed comparable oncologic outcomes related to recurrence and survival. Despite extensive research efforts, neither the incidence of port-site recurrence nor its causes have been clarified definitely. However, according to the preliminary results of recently published studies, the problem of port-site metastases may not be an inherited detriment of laparoscopic surgery, but rather an unfortunate sequel to the learning curve of the application of laparoscopic surgery in colorectal cancer. Finally, as long-term results of prospective randomized trials are still missing, the crucial issue whether laparoscopic resection for colorectal cancer is oncologically equivalent to open surgery, cannot be answered definitely. Therefore, in the interim, laparoscopic curative resections in colorectal cancer are only to be offered within prospective randomized trials.

Laparoscopic versus open total mesorectal excision with anal sphincter preservation for low rectal cancer

“…Increasingly more colorectal surgeons employ this procedure as the gold standard for rectal cancer [14,18,25]. The laparoscopic approach has been applied to colorectal surgery for many years, and its feasibility has been shown in a variety of colorectal operations [4,5,38]. However, most procedures related to the TME for rectal cancer were either laparoscopicassisted abdominoperineal resection for distal rectal cancer [17,22] or anterior resection for proximal rectal cancer [6,11,35].…”

Investigation of free cancer cells in peripheral blood using CEA mRNA expression in perioperative colorectal cancer patients

“…However, despite the rapid rise in the popularity of this technique, data on its oncological safety are limited (12,13). …”

Laparoskopische kolorektale Resektionen bei benignen Polypen

“…Diese Vorteile gelten als akzeptiert für die chirurgische Therapie verschiedener kolorektaler Erkrankungen, so zum Beispiel für die Behandlung von Beckenbodenfunktionsstörun-gen, der Divertikultis sowie bestimmter Verläufe des Morbus Crohn [12]. Vor diesem Hintergrund erscheint die minimalinvasive Methodik auch für die Therapie benigner adenomatöser Tumoren des Kolon als besonders geeignet.…”