Is laparoscopic technique oncologically appropriate for colorectal cancer surgery?

The role of laparoscopy for curative colorectal cancer surgery remains a topic of much debate. Even though, two oncologic issues, abdominal wall cancer recurrence and adequacy of intraperitoneal staging, are still of major concern, we believe that abdominal wall cancer recurrence may be largely avoidable using the appropriate surgical oncologic principles. In addition, laparoscopy appears to be quite valuable for accurate staging if used in combination with laparoscopic ultrasonography. The question, "Is laparoscopic technique oncologically appropriate for colorectal cancer surgery?", cannot be answered clearly until long-term recurrence and survival rates have been determined in a large number of patients undergoing curative laparoscopic cancer surgery. We, however, have still not had a single port-site recurrence at the Cleveland Clinic to date, having performed over eighty curative colectomies for cancer (performed only in a prospective randomized study) with a median follow-up of approximately two and half years.