LAPAROSCOPIC COLECTOMY FOR CANCER - A REVIEW

Background: The success of laparoscopic cholecystectomy in providing p atient benefits in the immediate postoperative period has led to lapar oscopic techniques being used for many other intra-abdominal procedure s. Colorectal resection for malignancy is one of the more contentious applications of this new technology, because the postoperative benefit s are more subtle and the long-term oncological results are as yet unk nown. Methods: A review of the English-language literature was underta ken in order to collate and analyse all published series where 20 or m ore laparoscopic colectomies were performed, and where the indication for resection in the majority of cases was adenocarcinoma of the colon . Results: Laparoscopic colectomy for cancer can be performed safely b y experienced surgeons, although there is a considerable learning curv e for the procedure. The expected benefits of minimal access surgery a re provided by laparoscopic colectomy, although to a lesser extent tha n that seen with other procedures. The oncological safety of the proce dure is as yet unproven. it is clear that an equivalent resection can be performed, but not whether this translates to an equivalent recurre nce and survival rate. Reports of isolated port-site recurrences are o f concern. Conclusions: Early results of laparoscopic colectomy for ca ncer are encouraging, although the fate of this procedure rests with t he analysis of the large multicentre prospective randomized trials cur rently under way, particularly with regard to the long-term recurrence and survival rates.