Long-term results of laparoscopic vs open resections for rectal cancer in 124 unselected patients

Excerpt

We read with interest the study by Feliciotti et al. [1]. They and others have demonstrated that laparoscopic resection of the rectum is technically feasible. We agree with some of their conclusions, including the need for mobilization of the splenic flexure and the low occurrence of port-site metastases. However, their main conclusion fails to support laparoscopic management of rectal cancer. A local recurrence rate of 18% at open surgery is unacceptably high and is not in keeping with internationally accepted recurrence rates. Total mesorectal excision (TME) has revolutionized rectal surgery, reducing rates of local recurrence to 3–5% [2, 3]. It has been demonstrated that intensive training programes can be used to train surgeons in this technique [4]. We believe that given their high local recurrence at both open and laparoscopic surgery, they have not proven the case for laparoscopic rectal resection. …