Laparoskopische Chirurgie beim kolorektalen Karzinom: Sind die onkologischen Standards einzuhalten?

Abstract

Laparoscopic Surgery for Colorectal Cancer: Are Oncologic Standards Respected? 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 problem of port-site metastases. Oncologic standards of open surgery for colorectal cancer seem to be not compromised by the laparoscopic approach. Short-term results of both retrospective and prospective trials comparing open with laparoscopic surgery for colorectal cancer showed comparable oncologic outcome 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 seems not be a specific problem of laparoscopic surgery, but rather an unfortunate sequel to the learning curve. Finally, as long-term results of prospective randomized trials are still missing, the fundamental issue whether laparoscopic resection for colorectal cancer is oncologically equivalent to open surgery cannot be answered definitely. Therefore, in the interim, laparoscopic curative resections for colorectal cancer are only to be offered within prospective randomized trials.