Wound recurrences following laparoscopic-assisted colectomy for cancer

Objectives: To determine the incidence and clinical relevance of wound recu rrences (WRs) following laparoscopic-assisted colectomy for cancer; to anal yze the most recent experimental studies examining possible pathogenic mech anisms; and to delineate possible prevention strategies. Data Sources: A MEDLINE search was conducted using the words "colectomy," " laparoscopy," and "recurrence. local." Additional articles were retrieved b y crossreferencing. Study Selection: All clinical and experimental studies retrieved were revie wed and subjectively selected according to their relevance for clinical pra ctice. Data Extraction: Clinical data from 1990 to 2000 with series analyzing SO o r more patients were preferentially considered. Experimental data were cons idered based on the most rigorous study designs and the potential impact of experimental findings on clinical practice. Data Synthesis: The incidence of WRs in large series and based on current t echniques is comparable to what has been reported for WR following open col ectomy. While the pathogenesis of early WR occurrences remains unclear, exp erience and appropriate training in laparoscopic-assisted colectomy are ess ential to minimize the incidence of WRs. Results from experimental studies are still controversial, and available data from prospective randomized cli nical trials are still limited. Conclusions: Results from prospective randomized trials are needed to provi de definitive answers regarding the incidence and survival impact of WRs. U ntil then, WR may be considered a technical complication following laparosc opic-assisted colectomy.