Update on prospective randomized trials of laparoscopic surgery for colorectal cancer.

Cosmetic improvement is perhaps the only conclusive advantage of laparoscopic colectomy for cancer. Previous retrospective studies repeatedly have demonstrated the feasibility and safety of this procedure. Although short-term prospective studies showed adequate cancer resection, comparable complication rates, and no increase in recurrence, issues of port site implantation, immune response and cost-efficiency remain unsolved. The ongoing clinical trials mentioned currently are evaluating the benefits and the potential risks of this technique as a cancer operation. Four trials will have completed accrual and three will be able to offer early analysis of the results by the year 2001. Until then, laparoscopic surgery for colorectal cancer should be considered investigational to be performed only as part of these above-mentioned trials.