ABSTRACT
Limited retrospective and prospective data suggest that early recurrence is similar in open and laparoscopic colectomy for cancer. This has softened the skepticism triggered by the increased rates of wound and trocar-site tumor implantation reported initially. Enthusiasm for the treatment of colon cancer with minimally invasive surgery and the stated oncologic concerns have prompted the initiation of trials around the world. Currently, there are eight prospective, national, and international trials defining whether laparoscopic colectomy has advantages over the open counterpart, and whether it compromises oncologic outcomes. These trials share the same aims: evaluation of the safety of the procedure, the quality of life, the cancer outcome, and cost analysis. The US National Institutes of Health (NIH) Laparoscopic versus Open Colectomy for Cancer Trial opened accrual in 1994, and has served as a model for others. Preliminary reports are encouraging, although final results are still not available. Only after these studies have been completed will the role of laparoscopic colectomy for cancer (LCC) be determined. Currently, the American Society of Colon and Rectal Surgery, as well as other national professional societies, recommend that laparoscopic colorectal surgery for cancer with curative intent should only be done in the setting of a randomized, prospective trial.
