Current evidence supporting indications for laparoscopic surgery in colorectal cancer

Laparoscopic surgery for colorectal cancer has been widely adopted in clinical practice. In this review, recent randomized controlled trials (RCTs) investigating laparoscopic surgery for colorectal cancer are analyzed and the current evidence is summarized to examine the validity of this approach.

We retrieved studies performed via a MEDLINE search to identify prospective RCTs on laparoscopic surgery for colorectal cancer after January 2000. Eligible RCTs were analyzed using the following items: publication year; geographical area and country; study theme; and sample size.

Forty RCTs were analyzed. Most RCTs were carried out in Europe and Asia. Laparoscopic surgery was shown to be, at least as effective as open surgery both in short-term and long-term outcomes and was demonstrated to be a minimally invasive surgery with less effect on homeostasis. Although bladder dysfunction was not, sexual dysfunction was more frequently found in the laparoscopic group in patients with either bulky or low rectal cancers.

Recent RCTs would validate the application of laparoscopic or laparoscopy-assisted surgery for colorectal cancer not only in patients with early colorectal cancer but also in advanced colorectal cancer.