Clinical status of laparoscopic bowel surgery for GI malignancy

Laparoscopic colorectal surgery is being utilized increasingly for benign d iseases, Recent published series have proven that morbidity and mortality f ront laparoscopic procedures are superior to those seen after traditional o pen procedures. However, although the technical feasibility of laparoscopic bowel resections has been confirmed, the oncologic advisability has not. T he procedures are not yet standards of care, due to port site recurrences, inadequate lymph node harvest, inadequate resection margins, and level of l igation, At present, laparoscopic bowel resection for cure of malignancy do es not confer significant benefits when compared to laparotomy and, indeed, has been associated with some serious problems. Long-term critical evaluat ion of large numbers of patients in prospective, randomized trials is neede d to define any merits of laparoscopy, Until such data become available, la paroscopy for attempted cure of colorectal malignancy should be performed o nly within the context of peer-reviewed, externally monitored, prospective, randomized trials. However, these techniques ave perfectly appropriate for palliation of metastatic disease.