Indikationen zur laparoskopischen Kolonresektion – auch beim Karzinom?

Abstract

In the last decade, laparoscopy has dramatically changed colonic surgery. Laparoscopic procedures are applied to the treatment of almost all colonic diseases, including both benign and malignant lesions. Significant benefits can be expected with a laparoscopic approach relative to decreased pain, ileus, length of hospital stay, disability, and possibly, adhesion formation and subsequent bowel obstruction, and improved cosmesis. However, all those benefits are secondary in the treatment of cancer; tumor-free survival must be the primary goal. Early comparative studies have shown that laparoscopic colectomy for cancer is safe, feasible, and an oncologic adequate resection can be performed with acceptable operative times and conversion rates. The most recent results of prospective randomized trials are now showing similar survival and cure rates after laparoscopic colectomy. There is evidence that laparoscopic colectomy for curable cancer results in equivalent cancer related survival compared to open colectomy when performed by experienced surgeons. The surgical techniques are demanding and require a level of standardization to achieve success. Laparoscopic colorectal surgery for cancer will have a definite role in the future.