Current status of laparoscopy for the treatment of rectal cancer

Abstract

Surgery for rectal cancer in complex and entails many challenges. While the laparoscopic approach in general and specific to colon cancer has been long proven to have short term benefits and to be oncologically safe, it is still a debatable topic for rectal cancer. The attempt to benefit rectal cancer patients with the known advantages of the laparoscopic approach while not compromising their oncologic outcome has led to the conduction of many studies during the past decade. Herein we describe our technique for laparoscopic proctectomy and assess the current literature dealing with short term outcomes, immediate oncologic measures (such as lymph node yield and specimen quality) and long term oncologic outcomes of laparoscopic rectal cancer surgery. We also briefly evaluate the evolving issues of robotic assisted rectal cancer surgery and the current innovations and trends in the minimally invasive approach to rectal cancer surgery.

Keywords: Laparoscopy; Rectal cancer; Minimally invasive surgery; Oncological outcomes; Short term benefits

Core tip: Surgery for rectal cancer entails many challenges and several debates exist regarding the appropriate way to deal with this disease. One of these debates is the choice of surgical approach and whether laparoscopy is appropriate. This article reviews the current knowledge about the use of the laparoscopic approach for rectal cancer. Herein we describe our technique for laparoscopic proctectomy and assess the current literature dealing with the outcomes and the oncologic safety of laparoscopic rectal cancer surgery. We also briefly evaluate the evolving issues of robotic assisted rectal cancer surgery and the current innovations in this field.