| Theme |
Colorectal endoscopic submucosal dissection |
| Title |
Present status and evaluation of laparoscopic colorectal surgery |
| Author |
Kazuhiko Hatate |
Department of Surgery, Kitasato University School of Medicine |
| Author |
Yukihito Kokuba |
Department of Surgery, Kitasato University School of Medicine |
| Author |
Atsushi Ihara |
Department of Surgery, Kitasato University School of Medicine |
| Author |
Masahiko Watanabe |
Department of Surgery, Kitasato University School of Medicine |
| [ Summary ] |
Successful laparoscopic surgery has been well developed for benign conditions such as gall bladder disease. Laparoscopic colectomies result in decreased postoperative pain, faster ileus resolution, shorter hospital stays, improved cosmesis, and decreased morbidity compared to open colectomies. Early reports of high rates of laparoscopic port site recurrence gave rise to questions regarding the adequacy of laparoscopic techniques for curative resection of malignancies. However, the incidence rates in recent randomized trials are much lower than in the initial reports. Laparoscopic resection for colon cancer is gaining acceptance in the light of the recent evidence concerning oncologic adequacy seen in randomized clinical trials. For rectal cancer the data is less clear. It seems that it may be feasible to resect at least small rectal cancers laparoscopically. The short and long term outcome of laparoscopic rectal cancer surgery depends on the quality and experience of the team treating the patient. Results from randomized controlled trials reporting long term outcomes, such as cancer recurrence and five-year survival rates, are eagerly awaited. Development of standardized treatments and education must be a goal to conduct all laparoscopic colorectal surgery safely. |