What is the established contribution of laparoscopy in the treatment of rectal cancer?

The results of laparoscopic treatment of rectal cancer have been evaluated in several randomized trials. Still, the validity of this approach remains controversial because of concerns regarding its oncological safety. In this review, oncological results of laparoscopic rectal resection were similar to those of laparotomy, with no observed survival difference. Conversion from laparoscopy to laparotomy seemed to be associated with worse oncological results and an increased post-operative morbidity including nervous sequelae. Intra-operative blood loss was significantly reduced with the laparoscopic approach, but post-operative morbidity was not different. Post-operative pain and length of hospital stay were decreased by the laparoscopic approach, and short-term quality of life was improved. There was no demonstration of significant reduction in late morbidity such as incisional hernia and bowel adhesions.