Current Applications of Laparoscopic Surgery in the Treatment of Rectal Cancer

 

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ABSTRACT

Laparoscopic surgical techniques still have not been adopted as a standard treatment for rectal cancer. Since having been first described, important steps have been undertaken to demonstrate oncologic principles including high vascular ligation, total mesorectal excision, and the preservation of the pelvic autonomic nerves. Most evidence regarding outcomes is based on small-scale retrospective or nonrandomized prospective studies. Recent data regarding the port-site recurrence are lower than initially reported and data regarding the long-term oncologic outcome have not shown disadvantages. We believe the proven short-term benefits of laparoscopic colon surgery are also applicable to laparoscopic rectal cancer surgery. In addition, this technique has the potential to allow a better oncologic resection with a better short-term functional outcome. This article will focus on current published experience and will also briefly describe the authors' technique and personal experience with this procedure.

REFERENCES

• 1 Leung K L, Yiu R Y, Lai P B, Lee J F, Thung K H, Lau W Y. Laparoscopic-assisted resection of colorectal carcinoma: five-year audit.  Dis Colon Rectum . 1999;  42 327-332
  PubMedGoogle Scholar
• 2 Milsom J W, Bohm B, Hammerhofer K. A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report.  J Am Coll Surg . 1998;  187 46-54
  CrossrefPubMedGoogle Scholar
• 3 Bruch H P, Schiedeck T H, Schwandner O. Laparoscopic colorectal surgery: a five-year experience.  Dig Surg . 1999;  16 45-54
  CrossrefPubMedGoogle Scholar
• 4 Leung K L, Kwok S P, Lau W Y. Laparoscopic-assisted abdominoperineal resection for low rectal adenocarcinoma.  Surg Endosc . 2000;  14 67-70
  CrossrefPubMedGoogle Scholar
• 5 Fleshman J W, Wexner S D, Anvari M. Laparoscopic versus open abdominoperineal resection for cancer.  Dis Colon Rectum . 1999;  42 930-939
  PubMedGoogle Scholar
• 6 Leung K L, Kwok S P, Lau W Y. Laparoscopic-assisted resection of rectosigmoid carcinoma. Immediate and medium-term results.  Arch Surg . 1997;  132 761-764
  PubMedGoogle Scholar
• 7 Tate J J, Kwok S, Dawson J W. Prospective comparison of laparoscopic and conventional anterior resection.  Br J Surg . 1993;  80 1396-1398
  PubMedGoogle Scholar
• 8 Kockerling F, Gastinger I, Schneider B. Laparoscopic abdominoperineal excision of the rectum with high ligation of the inferior mesenteric artery in the management of rectal carcinoma.  Endosc Surg Allied Technol . 1993;  1 16-19
  PubMedGoogle Scholar
• 9 Kockerling F, Gastinger I, Schneider B. Laparoscopic abdomino-perineal resection of the rectum with high intersection of the inferior mesenteric artery.  Chirurg . 1992;  63 345-348
  PubMedGoogle Scholar
• 10 Franklin Jr E M, Rosenthal D, Norem R F. Prospective evaluation of laparoscopic colon resection versus open colon resection for adenocarcinoma. A multicenter study.  Surg Endosc . 1995;  9 811-816
  PubMedGoogle Scholar
• 11 Lacy A M, Garcia-Valdecasas J C, Pique J M. Short-term outcome analysis of a randomized study comparing laparoscopic vs open colectomy for colon cancer.  Surg Endosc . 1995;  9 1101-1105
  PubMedGoogle Scholar
• 12 MacFarlane J K, Ryall R D, Heald R J. Mesorectal excision for rectal cancer.  Lancet . 1993;  341 457-460
  CrossrefPubMedGoogle Scholar
• 13 Milsom J W, Bohm B, Decanini C, Fazio V W. Laparoscopic oncologic proctosigmoidectomy with low colorectal anastomosis in a cadaver model.  Surg Endosc . 1994;  8 1117-1123
  CrossrefPubMedGoogle Scholar
• 14 Franklin Jr E M, Rosenthal D, Abrego-Medina D. Prospective comparison of open versus laparoscopic colon surgery for carcinoma. Five-year results.  Dis Colon Rectum . 1996;  39 S35-S46
  PubMedGoogle Scholar
• 15 Hartley J E, Mehigan B J, Qureshi A E. Total mesorectal excision: assessment of the laparoscopic approach.  Dis Colon Rectum . 2001;  44 315-321
  CrossrefPubMedGoogle Scholar
• 16 Decanini C, Milsom J W, Bohm B, Fazio V W. Laparoscopic oncologic abdominoperineal resection.  Dis Colon Rectum . 1994;  37 552-558
  PubMedGoogle Scholar
• 17 Bohm B, Milsom J W, Kitago K. Use of laparoscopic techniques in oncologic right colectomy in a canine model.  Ann Surg Oncol . 1995;  2 6-13
  PubMedGoogle Scholar
• 18 Weiser M R, Milsom J W. Laparoscopic total mesorectal excision with autonomic nerve preservation.  Semin Surg Oncol . 2000;  19 396-403
  CrossrefPubMedGoogle Scholar
• 19 Milsom J W, Jerby B L, Kessler H. Prospective, blinded comparison of laparoscopic ultrasonography versus contrast-enhanced computerized tomography for liver assessment in patients undergoing colorectal carcinoma surgery.  Dis Colon Rectum . 2000;  43 44-49
  PubMedGoogle Scholar
• 20 Leung K L, Lai P B, Ho R L. Systemic cytokine response after laparoscopic-assisted resection of rectosigmoid carcinoma: a prospective randomized trial.  Ann Surg . 2000;  231 506-511
  CrossrefPubMedGoogle Scholar
• 21 Fleshman J W, Nelson H, Peters W R. Early results of laparoscopic surgery for colorectal cancer. Retrospective analysis of 372 patients treated by Clinical Outcomes of Surgical Therapy (COST) Study Group.  Dis Colon Rectum . 1996;  39 S53-S58
  CrossrefPubMedGoogle Scholar
• 22 Ramos J R, Petrosemolo R H, Valory E A. Abdominoperineal resection: laparoscopic versus conventional.  Surg Laparosc Endosc . 1997;  7 148-152
  CrossrefPubMedGoogle Scholar
• 23 Wu J S, Birnbaum E H, Fleshman J W. Early experience with laparoscopic abdominoperineal resection.  Surg Endosc . 1997;  11 449-455
  CrossrefPubMedGoogle Scholar
• 24 Schiedeck T H, Schwandner O, Baca I. Laparoscopic surgery for the cure of colorectal cancer: results of a German five-center study.  Dis Colon Rectum . 2000;  43 1-8
  CrossrefPubMedGoogle Scholar