Laparoscopy for colon cancer: state of the art.

As a result of several years of trials and investigations, laparoscopic colectomy for colon cancer is now considered an acceptable and safe alternative to traditional open techniques. Four large randomized trials (Barcelona, COST, COLOR, CLASSIC) have shown the noninferiority of laparoscopic colectomy in overall survival, disease-free survival, and overall and local recurrences. Laparoscopic surgery is associated with better short-term outcomes, such as shorter hospital stay, shorter duration of ileus, less narcotic usefulness and postoperative pain, and a faster postoperative recovery. The procedures are also safe and feasible in elderly patients. Hand-assisted laparoscopic colectomy is a recent hybrid technique that could reduce learning time, and its role has been established in more challenging procedures. Future prospects include robotic and natural-orifice surgery.