Περίληψη:
Background/Aims: As laparoscopic colectomy finds its place in the
surgical armamentarium, the literature concerning the safety, efficacy,
and oncological rational for treatment of colonic cancer is also
enriched. A review and critical appraisal of the literature on this
subject was the aim of this paper. Methods: A systematic research and a
hand search were conducted to gain access to all controlled studies
involving laparoscopic colectomy using the Medline, Embase, HealthSTAR,
Cumulative Index for Nursing and Allied Health Literature, CancerLit
data bases and the Cochrane Central Register of Controlled Trials for
the years 1991-2006. Results: Over 40 controlled randomized trials and
ten systematic reviews and/or meta-analyses were found. Several of the
completed controlled randomized trials have published either short- or
long-term results; only partial and short- term results are available in
rectal cancer. The principal conclusions are that the laparoscopic
approach affords better short- term outcomes including surgical site
morbidity, but with increased operative times and direct costs. Among
the proven long-term outcomes, cancer recurrence and survival do not
seem to be worse. Whether conversion, a source of increased operative
time and costs, is responsible for poorer outcomes or whether specific
settings associated with poorer outcomes are among the causes of
conversion remains to be shown. However, there are still concerns as
regards specific laparoscopic-related complications. Conclusion: There
seems to no real safety problems in performing laparoscopic colectomy
for cancer; improvement in operative times, conversion rates, and
complications should make laparoscopy the best cost-effective approach
to colectomy. Copyright (c) 2007 S. Karger AG, Basel
Συγγραφείς:
Fingerhut, Abe
Ata, Toufik
Chouillard, Elie
Alexakis,
Nicholas
Veyrie, Nicolas
Λέξεις-κλειδιά:
colonic cancer, laparoscopic approach; laparoscopic colectomy;
laparoscopic colonic resection; laparoscopic surgery, review of
literature
