[Outcome evaluation based on evidence-based medicine of laparoscopic surgery for rectal cancer]

Laparoscopic surgery of rectal cancer has experienced more than 20 years of technical development and clinical research. Based on the published high-level clinical trials such as COREAN, COLOR Ⅱ, ACOSOG Z6051 and ALacaRT, laparoscopic surgery is recommended as method to treat rectal cancer by the NCCN Clinical Practice Guideline on Rectal Cancer (version 1.2016) with class 2A evidence. But it is also suggested that the surgeons should have experiences of performing minimally invasive proctectomy with total mesorectal excision. It is not recommended for the cases of locally advanced disease with a threatened or high risk circumferential resection margin based on staging. For those patients with high risk tumors, open surgery is preferred. Further analysis of the clinical trials has shown that surgical technique and circumferential resection margin are the key factors that affect the outcomes of laparoscopic rectal cancer surgery. Therefore, the wide application of laparoscopic surgery in the treatment of rectal cancer still needs more evidence-based clinical trials to test and prove.