Could Laparoscopic Colorectal Cancer Surgery Become the Adequate Procedure?

Abstract

Laparoscopic surgery became popular in the early 1990s. The successful application of laparoscopic surgery to gallbladder disease has encouraged surgeon to develop this technology to care other pathologic disorders of the gastrointestinal tract. Laparoscopic technique are being applied to the management of colorectal malignant disease. The advantage of laparoscopic colectomy is to reduce postoperative pain and analgesic requirement, earlier return of bowel function and normal physical activities, and shorter hospital stay. Pathologic examination of laparoscopically resected specimens has shown that adequate mesenteric lymph node excision and distal resection margin. Laproscopic surgery can be accomplished with acceptable morbidity and mortality when performed by trained surgeons. Despite initial early alarming reports of port site cancer recurrence in laparoscopically assisted colectomy, port site recurrence is rare and its incidence is similar to incisional wound recurrences in conventional open colectomy. Recent prospective comparative studies have demonstrated equivalent patient survival and local or distant colon cancer recurrences for open versus laparoscopic curative resection of colon cancer. However, we must await the final result of large prospective randomized studies before drawing any definitive conclusion.