Laparoscopic Approaches to Colonic Malignancy

  • L. Stocchi
  • Heidi Nelson

Abstract

The last decade has witnessed the surge and success of laparoscopic approaches in several surgical arenas. Laparoscopic cholecystectomy has become the standard of care, Nissen fundoplication has replaced the open approach in many cases, and successful applications of the laparoscopic technique for splenectomy and adrenalectomy are increasingly reported. Although laparoscopic-assisted colectomy (LAC) has been shown to be technically safe and feasible, the laparoscopic approach to colonic malignancy remains controversial. Besides technical difficulties, the extent of patient-related benefits is unclear. In addition, concerns over the appropriateness of laparoscopic colectomy for cancer have been raised with regard to possible limitations in tumor staging, patterns of tumor recurrences related to the use of a pneumoperitoneum, and effective cost containment. The laparoscopic approach for palliative procedures appears attractive but has not been extensively reported. Therefore, it is increasingly clear that well-designed prospective randomized trials are necessary to support laparoscopic colectomy as an alternative technique for colon cancer. This chapter analyzes the technical aspects of laparoscopic colectomy as a cancer operation, discusses the results expected with LAC, addresses cancer staging and unusual patterns of tumor recurrence, and describes the design and purpose of the National Cancer Institute (NCI)-sponsored prospective randomized trial.

Keywords

Laparoscopic Approach Laparoscopic Colectomy Laparoscopic Colorectal Surgery Open Colectomy Laparoscopic Ultrasonography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • L. Stocchi
  • Heidi Nelson

There are no affiliations available

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