The Feasibility and Role of Laparoscopic Surgery in Rectal Cancer

The use of the laparoscopic approach for the treatment of rectal tumors remains controversial. This review summarizes all the published level 1 and some level 2 evidence, much of which is not included in recent meta-analyses. The current evidence base demonstrates short-term benefits in the laparoscopic group without compromising 35 year survival or recurrence. Quality-of-life indices demonstrate benefits until 1 year but not beyond. Further randomized clinical trials are required to investigate the impact on lymph node yield and genitourinary function, and a minimum dataset might be helpful for the design of future studies. We conclude that the laparoscopic approach is both feasible and desirable in the context of a well-trained surgeon and has a clear role in the management rectal cancer in all but emergent and T4 cases.