Cáncer Colorectal

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World J Gastroenterol 2011 February 21; 17(7): 862-866 ISSN 1007-9327 (print) ISSN 2219-2840 (online)

© 2011 Baishideng. All rights reserved.

TOPIC HIGHLIGHT Imran Hassan, MD, Assistant Professor, Series Editor

Minimally invasive surgery for rectal cancer: Are we there yet?
Bradley JChampagne, Rohit Makhija
Bradley J Champagne, Division of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, OH 44106, United States Rohit Makhija, Laparoscopic Colorectal Fellow, University Hospitals Case Medical Center, Cleveland, OH 44106, United States Author contributions: Champagne BC wrote the paper, performed a literature search, analyzed data; Makhija R performedliterature search and contributed to writing the paper. Correspondence to: Bradley J Champagne, MD, FACS, Associate Professor, Division of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, OH 44106, United States. brad.champagne@uhhospitals.org Telephone: +1-216-5267221 Fax: +1-216-8445957 Received: September 26, 2010 Revised: December 16, 2010 Accepted: December 23, 2010Published online: February 21, 2011 Champagne BJ, Makhija R. Minimally invasive surgery for rectal cancer: Are we there yet? World J Gastroenterol 2011; 17(7): 862-866 Available from: URL: http://www.wjgnet. com/1007-9327/full/v17/i7/862.htm DOI: http://dx.doi. org/10.3748/wjg.v17.i7.862

INTRODUCTION
The benefits of laparoscopic colon surgery compared to the open approach are well established[1-4].Furthermore, laparotomy has been associated with an increased morbidity when compared to minimally invasive techniques for colorectal disease[5]. More recently, the implementation of enhanced care programs coupled to laparoscopic resection has also resulted in a significant reduction in length of stay after both colon and rectal resection[6,7]. Laparoscopic colon surgery for select cancers isslowly evolving as the standard of care but minimally invasive approaches for rectal cancer have been viewed with significant skepticism. Laparoscopic rectal resection for cancer is performed by select surgeons at specialized centers. The variability in anatomic definitions of the rectum, technique, selection criteria, and need for neoadjuvant therapy amongst this group of surgeons have made parallelcomparisons difficult and ambiguous. Concern over local recurrence, sexual dysfunction and appropriate training measures have further hindered widespread acceptance of this approach. This opinion addresses short-term and oncological outcomes for laparoscopic resection of rectal cancer, the aforementioned obstacles, and current controversies regarding technical approaches.

AbstractLaparoscopic colon surgery for select cancers is slowly evolving as the standard of care but minimally invasive approaches for rectal cancer have been viewed with significant skepticism. This procedure has been performed by select surgeons at specialized centers and concerns over local recurrence, sexual dysfunction and appropriate training measures have further hindered widespread acceptance. Data forlaparoscopic rectal resection now supports its continued implementation and widespread usage by expeienced surgeons for select patients. The current controversies regarding technical approaches have created ambiguity amongst opinion leaders and are also addressed in this review.
© 2011 Baishideng. All rights reserved.

Key words: Laparoscopic; Rectal cancer; Minimally invasive; Mesorectal excisionPeer reviewer: Dr. Stefan Riss, Department of Surgery, Medical University of Vienna, Vienna, 1090, Austria

ONCOlOgICal OUTCOmes
There are many potential endpoints for determining success for laparoscopic rectal resection. Undoubtedly, the

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February 21, 2011|Volume 17|Issue 7|

Champagne BJ et al . Evidence for laparoscopic rectal resection

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