Published online May 7, 2014. doi: 10.3748/wjg.v20.i17.4900
Revised: December 7, 2013
Accepted: January 14, 2014
Published online: May 7, 2014
Despite established evidence on the advantages of laparoscopy in colon cancer resection, the use of laparoscopy for rectal cancer resection is still controversial. The initial concern was mainly regarding the feasibility of laparoscopy to achieve an adequate total mesorectal excision specimen. These concerns have been raised following early studies demonstrating higher rates of circumferential margins positivity following laparoscopic resection, as compared to open surgery. Similar to colon resection, patients undergoing laparoscopic rectal cancer resection are expected to benefit from a shorter length of hospital stay, less analgesic requirements, and a faster recovery of bowel function. In the past decade there have been an increasing number of large scale clinical trials investigating the oncological and perioperative outcomes of laparoscopic rectal cancer resection. In this review we summarize the current literature available on laparoscopic rectal cancer surgery.
Core tip: Despite its endorsement for colon cancer resection, laparoscopy for rectal cancer resection is still considered investigational. This is mainly due to initial concerns regarding the feasibility of laparoscopy to achieve an adequate total mesorectal excision specimen. These concerns have been raised following early studies demonstrating higher rates of circumferential margins positivity following laparoscopic resection, as compared to open surgery. In this review, we explore the current relevant literature regarding laparoscopic resection for rectal cancer, with respect to oncologic efficacy and short and long term benefits.