Laparoscopic anterior resection for rectal carcinoma. Results of a registry

At the present time, laparoscopic anterior resection of the rectum cannot be recommended for routine use. Such operations should be performed for curative intent only within scientifically valid studies. Furthermore, only interventions involving the upper part of the rectum or the rectosigmoidal junction can, on the basis of the morbidity rate, be justified. Procedures done on the low rectum necessitating a total mesorectal excision technically are difficult and, in the present study, are associated with a significant increase in morbidity, in particular anastomotic leakage. Therefore, tumors in the lower two thirds of the rectum that may be eligible for restorative proctectomy should not be treated for curative intent by the laparoscopic approach. General reservations also persist with regard to compliance with the principles of oncologic radicality.