(1) TriHealth, Cincinnati, United States
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Although large multicenter randomized controlled trials have shown no difference in long term disease free or overall survival between open and laparoscopic approaches for colon cancer, the same has not been uniformly appreciated for rectal cancer. Some of the main questions regarding the safety and efficacy of minimally invasive surgery for rectal cancer is whether an equivalent total mesorectal excision, lymphadenectomy, circumferential resection margin involvement, local recurrence, disease free survival, and overall survival can be obtained in comparison to conventional open surgery. Our aim was to systematically review the current randomized controlled trials in the literature comparing minimally invasive and open rectal cancer surgery.
Studies reviewed in this paper revealed comparative oncologic results and outcomes, though most are single institution studies with small sample sizes, and long term outcomes are scarce.
Larger multi-institutional studies such as ASCOG Z6051 and COLOR II will help us answer the question regarding long term oncologic results in regards to minimally invasive surgery for rectal cancer. Until then, it is recommended that minimally invasive surgery for rectal cancer be conducted within a randomized controlled trial.