Results of the Laparoscopic Colon Cancer Randomized Trials: An Evidence-Based Review

Concerns over the oncologic safety of laparoscopic colectomy for colorectal cancer have resulted in extensive comparisons with open surgery in the form of randomized trials. From the current review of the best available literature, we conclude that laparoscopic resection for colon cancer is associated with numerous short-term benefits, including decreased postoperative pain and analgesia requirements, speedier recovery of bowel function, shorter length of stay in hospital, and potentially a decreased rate of wound infection. As well, patients undergoing laparoscopic colectomy may demonstrate benefits in quality of life, particularly in terms of social functioning. Cost analyses have demonstrated comparable overall net costs between laparoscopic and open colectomy for cancer, despite higher operative costs associated with laparoscopy. Randomized studies have also demonstrated that laparoscopic and open colectomy for cancer yield equivalent and satisfactory oncologic resections, in terms of both number of lymph nodes retrieved and resection margins, when performed by experienced surgeons. Finally, long-term outcomes have been shown to be equivalent in terms of 3- and 5-year survival rates, as well as disease-free survival, and similar rates for wound/port site tumor recurrences.