This paper compares laproscopic surgery for coloncancer with open operation. The mail goal is to decide whether laparoscopic surgery is safe as to pre-, intra- and postoperative risk, survival and the oncologic principles. The paper is mainly based on 10 randomized, controlled trials.
Results: Laparoscopic surgery is more expensive than open surgery, because of longer operation time and more expensive equipment. The expences can to a certain degree be compensated by a shorter hospital stay. For the society as a whole, laparoscopic surgery is not more expensive, since the patients earlier can take care of them selves. Laparoscopic sugery is associated wíth less pain, the patients can quicklier eat as normal, they have earlier bowel movement and can earlier go home from the hospital.
The oncologic principles is taken care of to the same extent in laparoscopic sugery as in open sugery. There are no differences between the groups in respect to the number of lymphnodes and positive resection margins. Port-site metastasis are now not more common than wound metastasis. Laparoscopic cancer surgery requires surgeons with experience from laparoscopic surgery and experience with open surgery. Long experience with laparoscopic surgery leads to less conversions which in turn leads to a better result. The patients needs to be througly examined pre-opeatively to be exactly sure of the tumors location, possible invation of neighbouring tissue and possible metastasis.
Conclusion: Laparoscopic surgery is a real alternative to open surgery in non-metastatic colon cancer, where tumor has not invaded neigbouring tissue.