Operative Standards zur Rektumresektion - Offen und laparoskopisch

Laparoscopic surgery of rectal cancer is a technical approach using a minimal access. It is atraumatic and offers by optical magnification and variation of the patients positioning an excellent exposition and thus an anatomy corresponding preparation plane. Different studies could verify a reduced loss of blood, better respiratory function and a smaller immuncompromitation with last but not least better cosmesis particularly for the younger patient. Nevertheless, in oncologic surgery these advantages become secondary while criteria like radicality, port-side metastases, tumor cell spread and patients long-term survival are of paramount importance. However, newer studies show that with greater experience of the operating surgeons, advanced technique and a stage-adjusted therapeutical strategy the oncologic criteria mentioned above can be fullfilled laparoscopically equivalent to those in open surgery. Nevertheless, as long as the final data of the multicentrical phase-III studies are not published the laparoscopic approach for curative rectal cancer treatment should only be performed under study conditions.