Laparoscopic resection of colon Cancer: Consensus of the European Association of Endoscopic Surgery (EAES)

  • R. Veldkamp
  • M. Gholghesaei
  • H. J. Bonjer
  • D. W. Meijer
  • M. Buunen
  • J. Jeekel
  • B. Anderberg
  • M. A. Cuesta
  • A. Cuschierl
  • A. Fingerhut
  • J. W. Fleshman
  • P. J. Guillou
  • E. Haglind
  • J. Himpens
  • C. A. Jacobi
  • J. J. Jakimowicz
  • F. Koeckerling
  • A. M. Lacy
  • E. Lezoche
  • J. R. Monson
  • M. Morino
  • E. Neugebauer
  • S. D. Wexner
  • R. L. Whelan
Original article



The European Association of Endoscopic Surgery (EAES) initiated a consensus development conference on the laparoscopic resection of colon cancer during the annual congress in Lisbon, Portugal, in June 2002.


A systematic review of the current literature was combined with the opinions, of experts in the field of colon cancer surgery to formulate evidence-based statements and recommendations on the laparoscopic resection of colon cancer.


Advanced age, obesity, and previous abdominal operations are not considered absolute contraindications for laparoscopic colon cancer surgery. The most common cause for conversion is the presence of bulky or invasive tumors. Laparoscopic operation takes longer to perform than the open counterpart, but the outcome is similar in terms of specimen size and pathological examination. Immediate postoperative morbidity and mortality are comparable for laparoscopic and open colonic cancer surgery. The laparoscopically operated patients had less postoperative pain, better-preserved pulmonary function, earlier restoration of gastrointestinal function, and an earlier discharge from the hospital. The postoperative stress response is lower after laparoscopic colectomy. The incidence of port site metastases is <1%. Survival after laparoscopic resection of colon cancer appears to be at least equal to survival after open resection. The costs of laparoscopic surgery for colon cancer are higher than those for open surgery.


Laparoscopic resection of colon cancer is a safe and feasible procedure that improves short-term outcome. Results regarding the long-term survival of patients enrolled in large multicenter trials will determine its role in general surgery.


Laparoscopic resection Colon cancer Contraindications Conversion Morbidity and mortality Outcomes Stress response Port site metastasis Costs 


  1. 1.
    Hilliard, G,  et al. 1990The elusion colonic malignancy: a need for definitive preoperative localization.Am Surg56742744PubMedGoogle Scholar
  2. 1.
    Ott, DJ 2000Accuracy of doublecontrast barium enema in diagnosing colorectal polyps and cancer.Semin Roentgenol35333341PubMedGoogle Scholar
  3. 3.
    Pijl, ME,  et al. 2002Radiology Colorectal cancer.Eur J Cancer38887898CrossRefPubMedGoogle Scholar
  4. 4.
    Bond, JH 2002Colorectal cancer screening: the potential role of virtual colonoscopy.J Gastroenterol379296Google Scholar
  5. 5.
    Delgado, S,  et al. 2000Could age be an indication for laparoscopic colectomy in colorectal cancer?Surg Endosc142226CrossRefPubMedGoogle Scholar
  6. 6.
    Schwandner, O, Schiedeck, TH, Bruch, HP 1999Advanced age—indication or contraindication for laparoscopic colorectal surgery?Dis Colon Rectum42356362PubMedGoogle Scholar
  7. 7.
    Lo, CM,  et al. 1996Laparoscopic cholecystectomy for acute cholecystitis in the elderly.World J Surg20983986discussion 987CrossRefPubMedGoogle Scholar
  8. 8.
    Pessaux, P,  et al. 2000Laparoscopic cholecystectomy in the elderly: a prospective study.Surg Endosc1410671069PubMedGoogle Scholar
  9. 9.
    Neudecker, J,  et al. 2002The EAES clinical practice guideline on the pneumoperitoneum for laparoscopic surgery.Surg Endosc1611211143CrossRefPubMedGoogle Scholar
  10. 10.
    Sprung, J,  et al. 2002The impact of morbid obesity, pneumoperitoneum, and posture on respiratory system mechanics and oxygenation during laparoscopy.Anesth Analg9413451350CrossRefPubMedGoogle Scholar
  11. 11.
    Pandya, S,  et al. 1999Laparoscopic colectomy: indications for conversion to laparotomy.Arch Surg134471475CrossRefPubMedGoogle Scholar
  12. 12.
    Pikarsky, AJ,  et al. 2002Is obesity a high risk factor for laparoscopic colorectal surgery?Surg Endosc16855858CrossRefPubMedGoogle Scholar
  13. 13.
    Angrisani, L,  et al. 1995Laparoscopic cholecyslectomy in obese patients compared with nonobese patients.Surg Laparosc Endosc5197201PubMedGoogle Scholar
  14. 14.
    Collet, D,  et al. 1992Laparoscopic cholecystectomy in the obese patient.Surg Endosc6186188PubMedGoogle Scholar
  15. 15.
    Miles, RH,  et al. 1992Laparoscopy: the preferred method of cholecystectomy in the morbidly obese.Surgery112818822discussion 822823PubMedGoogle Scholar
  16. 16.
    Phillips, EH,  et al. 1994Comparison or laparoscopic cholecystectomy in obese and non-obese patients.Am Surg60316321PubMedGoogle Scholar
  17. 17.
    Schirmer, BD,  et al. 1992Laparoscopic cholecystectomy in the obese patient.Ann Surg216146152PubMedGoogle Scholar
  18. 18.
    Unger, SW,  et al. 1991Laparoscopic approach to gallstones in the morbidly obese patient.Surg Endosc5116117PubMedGoogle Scholar
  19. 19.
    Nelson, H,  et al. 2001Guidelines 2000 for colon and rectal cancer surgery.J Natl Cancer Inst93583596CrossRefPubMedGoogle Scholar
  20. 20.
    Hamel, CT,  et al. 2000Do prior abdominal operations after the outcome of laparoscopically assisted right hemicolectomy?Surg Endosc14853857CrossRefPubMedGoogle Scholar
  21. 21.
    BoulangerA Hardy, JF 1987[Intestinal distention during elective abdominal surgery: should nitrous oxide be banished?].Can J Anaesth34346350PubMedGoogle Scholar
  22. 22.
    Taylor, E,  et al. 1992Anesthesia for laparoscopic cholecystectomy: is nitrous oxide contraindicated?Anesthesiology76541543PubMedGoogle Scholar
  23. 23.
    Zmora, O, Weiss, EG 2001Trocar site recurrence in laparoscopic surgery for colorectal cancer: myth or real concern?Surg Oncol Clin North Am10625638Google Scholar
  24. 24.
    Bouvy, ND,  et al. 1996Impact of gas(less) laparoscopy and laparotomy on peritoneal tumor growth and abdominal wall metastases.Ann Surg224694700 discussion 700701CrossRefPubMedGoogle Scholar
  25. 25.
    Montorsi, M,  et al. 1995Early parietal recurrence of adenocarcinoma of the colon after laparoscopic colectomy.Br J Surg8210361037PubMedGoogle Scholar
  26. 26.
    Watson, DI,  et al. 1997Gasless laparoscopy may reduce the risk of port-site metastases following laparaccopic tumor surgery.Arch Surg132166168discussion 169PubMedGoogle Scholar
  27. 27.
    Gutt, CN,  et al. 1999Impact of laparoscopic colonic resection on tumour growth and spread in an experimental model.Br J Surg8611801184CrossRefPubMedGoogle Scholar
  28. 28.
    Iwanaka, T, Arya, G, Ziegler, MM 1998Mechanism and prevention of port-site tumor recurrence after laparoscopy in a murine model.J Pediatr Surg33457461CrossRefPubMedGoogle Scholar
  29. 29.
    Wittich, P,  et al. 2000Intraperitoneal tumor growth is influenced by pressure of carbon dioxide pneumoperitoneum.Surg Endosc14817819CrossRefPubMedGoogle Scholar
  30. 30.
    Gutt, CN,  et al. 1997The phagocytisis activity during conventional and laparoscopic operations in the rat: a preliminary study.Surg Endosc11899901CrossRefPubMedGoogle Scholar
  31. 31.
    West, MA, Baker, J, Bellingham, J 1996Kinetics of decreased LPS-stimulated cytokine release by macrophages exposed to CO2.J Surg Res63269274CrossRefPubMedGoogle Scholar
  32. 32.
    Hajri, A,  et al. 2000Dual effect of laparoscopy on cell-mediated immunity.Eur Surg Res322616CrossRefPubMedGoogle Scholar
  33. 33.
    Jacobi, CA,  et al. 2001The impact of conventional and laparoscopic colon resection (CO2 or helium) on intraperitoneal adhesion formation in a rat peritonitis model.Surg Endosc15380386CrossRefPubMedGoogle Scholar
  34. 34.
    Nagelschmidt, M, Gerbecks, D, Minor, T 2001The impact of gas laparoscopy on abdominal plasminogen activator activity.Surg Endosc15585588CrossRefPubMedGoogle Scholar
  35. 35.
    Neuhaus, SJ,  et al. 1998Tumor implantation following laparoscopy using different insufflation gases.Surg Endosc1213001302CrossRefPubMedGoogle Scholar
  36. 36.
    Jacobi, CA,  et al. 1999Influence of different gases and intraperitoneal instillation of antiadherent or cytotoxic agents on peritoneal tumor cell growth and implantation with laparoscopic surgery in a rat model.Surg Endosc1310211025CrossRefPubMedGoogle Scholar
  37. 37.
    Bouvy, ND,  et al. 1998Effects of carbon dioxide pneumoperitoneum, air pneumoperitoneum, and gasless laparoscopy on body weight and tumor growth.Arch Surg133652656CrossRefPubMedGoogle Scholar
  38. 38.
    Wu, JS,  et al. 1998Excision of trocar sites reduces tumor implantation in an animal model.Dis Colon Rectum4111071111PubMedGoogle Scholar
  39. 39.
    Watson DI, et al. (2002) Excision of laparoscopic port sites increases the likelyhood of wound metastases in an experimental model. 8th World Congress of Endoscopic Surgery, New York, NY, USA. BS01(final program): 77Google Scholar
  40. 40.
    Neuhaus, SJ,  et al. 1999Influence of cytotoxic agents on intraperitoneal tumor implantation after laparoscopy.Dis Colon Rectum421015PubMedGoogle Scholar
  41. 41.
    Lee, SW,  et al. 1999Peritoneal irrigation with povidone-iodine solution after laparoscopic-assisted splenectomy significantly decreases port-tumor recurrence in a murine model.Dis Colon Rectum42319326PubMedGoogle Scholar
  42. 42.
    Neuhaus, SJ,  et al. 1999Experimental study of the effect of intraperitoneal heparin on tumour implantation following laparoscopy.Br J Surg86400404CrossRefPubMedGoogle Scholar
  43. 43.
    Braumann, C,  et al. 2000influence of intraperitoneal and systemic application of taurolidine and taurolidine/heparin during laparoscopy on intraperitoneal and subcutaneous tumour growth in rats.Clin J Exp Metastasis18547552CrossRefGoogle Scholar
  44. 44.
    Jacobi, CA,  et al. 1999New therapeutic strategies to avoid intra- and extraperitoneal metastases during laparoscopy: results of a tumor model in the rat.Dig Surg16393399CrossRefPubMedGoogle Scholar
  45. 45.
    Eshraghi, N,  et al. 1999Topical treatments of laparoscpoic port sites can decrease the incidence of incision metastasis.Surg Endosc1311211124CrossRefPubMedGoogle Scholar
  46. 46.
    Tseng, LN,  et al. 1998Port-site metastases: impact of local tissue trauma and gas leakage.Surg Endosc1213771380CrossRefPubMedGoogle Scholar
  47. 47.
    Wittich, P,  et al. 2000Port-site metastases after CO(2) laparoscopy: is aerosolization of tumor cells a pivotal factor?Surg Endosc14189192CrossRefPubMedGoogle Scholar
  48. 48.
    Whelan, RL,  et al. 1996Trocar site recurrence is unlikely to result from aerosolization of tumor cells.Dis Colon Rectum39S7S13PubMedGoogle Scholar
  49. 49.
    Turnbull, RB,Jr,  et al. 1967Cancer of the colon: the influence of the no-touch isolation technique on survival rates.Ann Surg166420427PubMedGoogle Scholar
  50. 50.
    Wiggers, T,  et al. 1988No-touch isolation technique in colon cancer: a controlled prospective trial.Br J Surg75409415PubMedGoogle Scholar
  51. 51.
    Gertsch, P,  et al. 1992Malignant cells are collected on circular staplers.Dis Colon Rectum35238241PubMedGoogle Scholar
  52. 52.
    Fermor, B,  et al. 1986Proliferative and metastatic potential of exfoliated colorectal cancer cells.J Natl Cancer Inst76347349PubMedGoogle Scholar
  53. 53.
    Umpleby, HC,  et al. 1984Viability of exfoliated colorectal carcinoma cells.Br J Surg71659663PubMedGoogle Scholar
  54. 54.
    Jenner, DC,  et al. 1998Rectal washout eliminates exfoliated malignant cells.Dis Colon Rectum4114321434PubMedGoogle Scholar
  55. 55.
    McDermott, JP, Devereaux, DA, Caushaj, PF 1994Pitfall of laparoscopic colectomy: an unrecognized synchronous cancer.Dis Colon Rectum37602603PubMedGoogle Scholar
  56. 56.
    Larach, SW,  et al. 1997Complications of laparoscopic colorectal surgery: analysis and comparison of early vs latter experience.Dis Colon Rectum40592596PubMedGoogle Scholar
  57. 57.
    Lacy, AM,  et al. 1995Is laparoscopic colectomy a safe procedure in synchronous colorectal carcinoma?Report of a Case. Surg Laparosc Endosc57576Google Scholar
  58. 58.
    Tabibian, N,  et al. 1988Use of an endoscopically placed clip can avoid diagnostic errors in colonoscopy.Gastrointest Endosc34262264PubMedGoogle Scholar
  59. 59.
    Ohdaira, T,  et al. 1999Intraoperative localization of colorectal tumors in the early stages using a marking clip detector system.Dis Colon Rectum4213531355PubMedGoogle Scholar
  60. 60.
    Hammond, DC,  et al. 1989Endoscopic tattooing of the colon: an experimental study.Am Surg55457461PubMedGoogle Scholar
  61. 61.
    Botoman, VA, Pietro, M, Thirlby, RC 1994Localization of colonic lesions with endoscopic tattoo.Dis Colon Rectum37775776PubMedGoogle Scholar
  62. 62.
    Waye, JD 1992Mucosal marking of the colon, or india ink tattoo of the colon: advanced therapeutic endoscopy.2Raven PressNew York209214Google Scholar
  63. 63.
    Coman, E,  et al. 1991Fat necrosis and inflammatory pseudotumor due to endoscopic tattooing of the colon with india ink.Gastrointest Endosc376568PubMedGoogle Scholar
  64. 64.
    Montorsi, M,  et al. 1999Original technique for small colorectal tumor localization during laparoscopic surgery.Dis Colon Rectum42819822PubMedGoogle Scholar
  65. 65.
    Cohen, JL, Forde, KA 1988Intraoperative colonoscopy.Ann Surg207231233PubMedGoogle Scholar
  66. 66.
    Fu, KII,  et al. 2001A new endosocopic tattooing technique for identifying the location of colonic lesions during laparoscopic surgery: a comparison with the conventional technique.Endoscopy33687691CrossRefPubMedGoogle Scholar
  67. 67.
    Nizam, R,  et al. 1996Colonic tattooing with India ink: benefits, risks, and alternatives.Am J Gastroenterol9118041808PubMedGoogle Scholar
  68. 68.
    Park, SI,  et al. 1991Colonic abscess and focal peritonities secondary to india ink tattooing of the colon.Gastrointest Endosc376871PubMedGoogle Scholar
  69. 69.
    Bernstein, MA,  et al. 1996Is complete laparoscopic colectomy superior to laparoscopic assisted colectomy?Am Surg62507511PubMedGoogle Scholar
  70. 70.
    Kurian, MS,  et al. 2001Hand-assisted laparoscopic surgery: an emerging technique.Surg Endosc1512771281CrossRefPubMedGoogle Scholar
  71. 71.
    Bemelman, WA,  et al. 1996Laparoscopic-assisted colectomy with the dexterity pneumo sleeve.Dis Colon Rectum39S59S61PubMedGoogle Scholar
  72. 72.
    Simons, AJ,  et al. 1995Laparoscopic-assisted colectomy learning curve.Dis Colon Rectum38600603PubMedGoogle Scholar
  73. 73.
    Schlachta, CM,  et al. 2001Defining a learning curve for laparoscopic colorectal resections.Dis Colon Rectum44217222PubMedGoogle Scholar
  74. 74.
    Bennett, CL,  et al. 1997The learning curve for laparoscopic colorectal surgery: preliminary results from a prospective analysis of 1194 laparoscopic-assisted colectomies.Arch Surg1324144 discussion 45PubMedGoogle Scholar
  75. 75.
    Lezoche, E,  et al. 2000Laparoscopic colonic resections versus open surgery: a prospective non-randomized study on 310 unselected cases.Hepatogastroenterology47697708PubMedGoogle Scholar
  76. 76.
    Kwok, SP,  et al. 1996Prospective evaluation of laparoscopic-assisted large bowel excision for cancer.Ann Surg223170176CrossRefPubMedGoogle Scholar
  77. 77.
    Milsom, JW,  et al. 1998A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report.J Am Coll Surg1874654discussion 54–55CrossRefPubMedGoogle Scholar
  78. 78.
    Falk, PM,  et al. 1993Laparoscopic colectomy: a critical appraisal.Dis Colon Rectum362834PubMedGoogle Scholar
  79. 79.
    Dean, PA,  et al. 1994Laparoscopic-assisted segmental colectomy: early Mayo Clinic experience.Mayo Clinic Proc69834840Google Scholar
  80. 80.
    Huscher, C,  et al. 1996Laparoscopic colorectal resection: a multicenter Italian study.Surg Endosc10875879CrossRefPubMedGoogle Scholar
  81. 81.
    Lauter, DM, Froines, EJ 2001Initial experience with 150 cases of laparoscopic assisted colectomy.Am J Surg181398403CrossRefPubMedGoogle Scholar
  82. 82.
    Lumley, JW,  et al. 1996Laparoscopic-assisted colorectal surgery: lessons learned from 240 consecutive patients.Dis Colon Rectum39155159PubMedGoogle Scholar
  83. 83.
    Phillips, EH,  et al. 1992Laparoscopic colectomy.Ann Surg216703707PubMedGoogle Scholar
  84. 84.
    Lezoche, E,  et al. 2002Laparoscopic vs open hemicolectomy for colon cancer.Surg Endosc16596602CrossRefPubMedGoogle Scholar
  85. 85.
    Marusch, F,  et al. 2001Experience as a factor influencing the indications for laparoscopic colorectal surgery and the results.Surg Endosc15116120CrossRefPubMedGoogle Scholar
  86. 86.
    Fielding, GA,  et al. 1994Laparoscopic colectomy.Surg Endosc11745749CrossRefGoogle Scholar
  87. 87.
    Curet, MJ,  et al. 2000Laparoscopically assisted colon resection for colon carcinoma: perioperative results and long-term outcome.Surg Endosc1410621066CrossRefPubMedGoogle Scholar
  88. 88.
    Bouvet, M,  et al. 1998Clinical, pathologic, and economic parameters of laparoscopic colon resection for cancer.Am J Surg176554558CrossRefPubMedGoogle Scholar
  89. 89.
    Lacy, AM,  et al. 2002Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial.Lancet35922242229CrossRefPubMedGoogle Scholar
  90. 90.
    Khalili, TM,  et al. 1998Colorectal cancer: comparison of laparoscopic with open approaches.Dis Colon Rectum41832838PubMedGoogle Scholar
  91. 91.
    Marubashi, S,  et al. 2000The usefulness, indications, and complications of laparoscopy-assisted colectomy in comparison with those of open colectomy for colorectal carcinoma.Surg Today30491496CrossRefPubMedGoogle Scholar
  92. 92.
    Leung, KL,  et al. 1997Laparoscopic-assisted resection of rectosigmoid carcinoma: immediate and medium-term results.Arch Surg132761764discussion 765PubMedGoogle Scholar
  93. 93.
    Lacy, AM,  et al. 1995Short-term outcome analysis of a randomized study comparing laparoscopic vs open coloctomy for colon cancer.Surg Endosc911011105CrossRefPubMedGoogle Scholar
  94. 94.
    Stage, JG,  et al. 1997Prospective randomized study of laparoscopic verus open colonic resection for adenocarcinoma.Br J Surg.84391396CrossRefPubMedGoogle Scholar
  95. 95.
    Bokey, EL,  et al. 1996Morbidity and mortality following laparoscopic-assisted right hemicolectomy for cancer.Dis Colon Rectum:39S24S28Google Scholar
  96. 96.
    Chapman, AE,  et al. 2001Laparoscopic assisted resection of colorectal malignancies a systematic review.Ann Surg234590606CrossRefPubMedGoogle Scholar
  97. 97.
    Wexner, SD,  et al. 1993Laparoscopic colorectal surgery: a prospective assessment and current perspective.Br J Surg8016021605PubMedGoogle Scholar
  98. 98.
    Lord, SA,  et al. 1996Laparoscopic resections for colorectal carcinoma: a three-year experience.Dis Colon Rectum39148154PubMedGoogle Scholar
  99. 99.
    Ye, TM, Cattey, RP, Henry, LG 1994Laparoscopically assisted colon resections compare favorably with open technique.Surg Laparosc Endosc:42531Google Scholar
  100. 100.
    Bonjer, HJ,  et al. 1997Open versus closed establishment of pneumoperitoneum in laparoscopic surgery.Br J Surg84599602CrossRefPubMedGoogle Scholar
  101. 101.
    Winslow ER, et al. (2002) Wound complication of laparoscopic vs open colectomy. 8th World Congress of Endoscopic Surgery, New York, NY, USA. Final program (S183): 120Google Scholar
  102. 102.
    Hewitt, PM,  et al. 1998Laparoscopic-assisted vs. open surgery for colerectal cancer: comparative study of immune effects.Dis Colon Rectum41901909PubMedGoogle Scholar
  103. 103.
    Bokey, EL,  et al. 1997Laparoscopic resection of the colon and rectum for cancer.Br J Surg.84822825CrossRefPubMedGoogle Scholar
  104. 104.
    Leung, KL,  et al. 1999Laparoscopic-assisted resection of right-sided colonic carcinoma: a case-control study.J Surg Oncol7197100CrossRefPubMedGoogle Scholar
  105. 105.
    Goh, YC, Eu, KW, Seow-Choen, F 1997Early postoperative results of a prospective series of laparoscopic vs. open anterior resections for rectosigmoid cancers.Dis Colon Rectum40776780PubMedGoogle Scholar
  106. 106.
    Tate, JJ,  et al. 1993Propective comparison of laparoscopic and conventional anterior resection.Br J Surg.8013961398PubMedGoogle Scholar
  107. 107.
    Gomis, F,  et al. 1998Early results of laparoscopic resection of colorectal cancer.Rev Esp Enferm Dig90323334Google Scholar
  108. 108.
    Leung, KL,  et al. 1999Laparoscopic-assisted resection of colorectal carcinoma: five-year audit.Dis Colon Rectum42327332discussion 332–333PubMedGoogle Scholar
  109. 109.
    Vara-Thorbeck, C,  et al. 1994Indications and advantages of laparoscopy-assisted colon resection for carcinoma in elderly patients.Surg Laparosc Endosc4110118PubMedGoogle Scholar
  110. 110.
    Lacy, AM,  et al. 1998Port site metastases, and recurrence after laparoscopic colectomy: a randomized trial.Surg Endosc1210391042CrossRefPubMedGoogle Scholar
  111. 111.
    Schwenk, W,  et al. 1999Pulmonary function following laparoscopic or conventional colorectal resection: a randomized controlled evaluation.Arch Surg134612discussion 13CrossRefPubMedGoogle Scholar
  112. 112.
    Hong, D, Tabet, J, Anvari, M 2001Laparoscopic vs. open resection for colorectal adenocarcinoma.Dis Colon Rectum441018discussion 1819PubMedGoogle Scholar
  113. 113.
    Kohler, L, Holthausen, U, Troidl, H 1997[Laparoscopic colorectal surgery—attempt at evaluating a new technology].Chirurg68794800 discussion 800CrossRefPubMedGoogle Scholar
  114. 114.
    Santoro, E,  et al. 1999Colorectal carcinoma: laparoscopic versus traditional open surgery.A clinical trial. Hepatogastroenterology46900904Google Scholar
  115. 115.
    Weeks, JC,  et al. 2002Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial.JAMA287321328CrossRefPubMedGoogle Scholar
  116. 116.
    Franklin, ME,Jr,  et al. 1996Prospective comparison of open vs. laparoscopic colon surgery for carcinoma: five-year results.Dis Colon Rectum39S35S46PubMedGoogle Scholar
  117. 117.
    Psaila, J,  et al. 1998Outcome following laparoscopic resection for colorectal cancer.Br J Surg85662664CrossRefPubMedGoogle Scholar
  118. 118.
    Franklin, ME,Jr, Rosenthal, D, Norem, RF 1995Prospective evaluation of laparoscopic colon resection versus open colon resection for adenocarcinoma: a multicenter study.Surg Endosc9811816PubMedGoogle Scholar
  119. 119.
    Wilmore, DW, Kehlet, H 2001Management of patients in fast track surgery.BMJ322473476CrossRefPubMedGoogle Scholar
  120. 120.
    Schwenk, W, Bohm, B, Muller, JM 1998Postoperative pain and fatigue after laparoscopic or conventional colorectal resections: a prospective randomized trial.Surg Endosc1211311136CrossRefPubMedGoogle Scholar
  121. 121.
    Hardacre, JM, Talamini, MA 2000Pulmonary and hemodynamic changes during laparoscopy—are they important?Surgery127241244CrossRefPubMedGoogle Scholar
  122. 122.
    Milsom, JW,  et al. 1994Use of laparoscopic techniques in colorectal surgery: preliminary study.Dis Colon Rectum37215218PubMedGoogle Scholar
  123. 123.
    Stead, ML,  et al. 2000Assessing the relative costs of standard open surgery and laparoscopic surgery in colorectal cancer in a randomised controlled trial in the United Kingdom.Crit Rev Oncol Hematol3399103CrossRefPubMedGoogle Scholar
  124. 124.
    Nelson, H, Weeks, JC, Wieand, HS 1995Proposed phase III trial comparing laparoscopic-assisted colectomy versus open colectomy for colon cancer.J Natl Cancer Inst Monogr195156PubMedGoogle Scholar
  125. 125.
    Anonymous,  2000COLOR: Dig Surg17617622CrossRefPubMedGoogle Scholar
  126. 126.
    Feliciotti, F,  et al. 2002Results of laparoscopic vs open resections for colon cancer in patients with a minimum follow-up of 3 years.Surg Endosc1611581161CrossRefPubMedGoogle Scholar
  127. 127.
    Hughes, ES,  et al. 1983Tumor recurrence in the abdominal wall scar tissue after large-bowel cancer surgery.Dis Colon Rectum26571572PubMedGoogle Scholar
  128. 128.
    Cass, AW, Million, RR, Pfaff, WW 1976Patterns of recurrence following surgery alone for adenocarcinoma of the colon and rectum.Cancer3728612865PubMedGoogle Scholar
  129. 129.
    Gunderson, LL, Sosin, H 1974Areas of failure found at reoperation (second or symptomatic look) following “curative surgery” for adenocarcinoma of the rectum: clinicopathologic correlation and implications for adjuvant therapy.Cancer3412781292PubMedGoogle Scholar
  130. 130.
    Berends, FJ,  et al. 1994Subcutaneous metastases after laparoscopic colectomy.Lancet34458CrossRefGoogle Scholar
  131. 131.
    Ortega, AE,  et al. 1995Laparoscopic Bowel Surgery Registry: preliminary results.Dis Colon Rectum.38681685discussion 685–686PubMedGoogle Scholar
  132. 132.
    Wexner, SD,  et al. 1995Laparoscopic colorectal surgery—are we being honest with our patients?Dis Colon Rectum38723727PubMedGoogle Scholar
  133. 133.
    Wexner, SD, Cohen, SM 1995Port site metastases after laparoscopic colorectal surgery for cure of malignancy.Br J Surg82295298PubMedGoogle Scholar
  134. 134.
    Wittich, P, Bonjer, HJ 2000Port-site recurrences in laparoscopic surgery.Kockerling, F eds. Port-site and wound recurrences in cancer surgery.HeidelbergSpringer-Verlag1220Google Scholar
  135. 135.
    Philipson, BM,  et al. 1997Cost of open versus laparoscopically assisted right hemicolectomy for cancer.World J Surg21214217CrossRefPubMedGoogle Scholar
  136. 136.
    Musser, DJ,  et al. 1994Laparoscopic colectomy: at what cost?Surg Laparosc Endosc415PubMedGoogle Scholar
  137. 137.
    Gutt, CN,  et al. 1997The phagocytosis activity during conventional and laparoscopic operations in the raT: a preliminary study.Surg Endosoc11899901CrossRefGoogle Scholar
  138. 138.
    Chekan, EG,  et al. 1999Intraperitoneal immunity and pneumoperitoneum.Surg Endosc1311351138CrossRefPubMedGoogle Scholar
  139. 139.
    Kloosterman, T,  et al. 1994Unimpaired immune functions after laparoscopic cholecystectomy.Surgery115424428PubMedGoogle Scholar
  140. 140.
    Schietroma, M,  et al. 2001Evaluation of immune response in patients after open or laparoscopic cholecystectomy.Hepatogastroenterology48642646PubMedGoogle Scholar
  141. 141.
    Liang, JT,  et al. 2002Prospective evaluation of laparoscopy-assisted colectomy versus laparotomy with resection for management of complex polyps of the sigmoid colon.World J Surg26377383CrossRefPubMedGoogle Scholar
  142. 142.
    Ordemann, J,  et al. 2001Cellular and humoral inflammatory response after laparoscopic and conventional colorectal resections.Surg Endosc15600608CrossRefPubMedGoogle Scholar
  143. 143.
    Eggermont, AM, Steller, EP, Sugarbaker, PH 1987Laparotomy enhances intraperitoneal tumor growth and abrogates the antitumor effects of interleukin-2 and lymphokine-activated killer cells.Surgery1027178PubMedGoogle Scholar
  144. 144.
    Schwenk, W,  et al. 2000Inflammatory response after laparoscopic and conventional colorectal resections—results of a prospective randomized trial.Langenbecks Arch Surg38529CrossRefPubMedGoogle Scholar
  145. 145.
    Wu, FPK,  et al. 2003Systemic and peritoneal inflammatory response after a laparoscopic or conventional colon resection in cancer patients: a prospective, randomized trial.Dis Colon Rectum46147155Google Scholar
  146. 146.
    Sietses, C,  et al. 2000Laparoscopic surgery preserves monocyte-mediated tumor cell killing in contrast to the conventional approach.Surg Endosc14456460CrossRefPubMedGoogle Scholar
  147. 147.
    Nishiguchi, K,  et al. 2001Comparative evaluation of surgical stress of laparoscopic and open surgeries for colorectal carcinoma.Dis Colon Rectum44223230PubMedGoogle Scholar
  148. 148.
    Kuntz, C,  et al. 2000Short- and long-term results after laparoscopic vs conventional colon resection in a tumor-bearing small animal model.Surg Endosc14561567CrossRefPubMedGoogle Scholar
  149. 149.
    Delgado, S,  et al. 2001Acute phase response in laparoscopic and open colectomy in colon cancer: randomized study.Dis Colon Rectum44638646PubMedGoogle Scholar
  150. 150.
    Fukushima, R,  et al. 1996Interleukin-6 and stress hormone responses after uncomplicated gasless laparoscopic-assisted and open sigmoid colectomy.Dis Colon Rectum39S29S34PubMedGoogle Scholar
  151. 151.
    Tang, CL,  et al. 2001Randomized clinical trial of the effect of open versus laparoscopically assisted colectomy on systemic immunity in patients with colorectal cancer.Br J Surg88801807CrossRefPubMedGoogle Scholar
  152. 152.
    Schiedeck, TH,  et al. 2000Laparoscopic surgery for the cure of colorectal cancer: results of a German five-center study.Dis Colon Rectum4318PubMedGoogle Scholar
  153. 153.
    Millikan, KW,  et al. 1996Superior mesenteric and portal vein thrombosis following laparoscopic-assisted right hemicolectomy: report of a case.Dis Colon Rectum3911711175PubMedGoogle Scholar
  154. 154.
    Franklin, ME,  et al. 2000Laparoscopic surgery for stage III colon cancer: long-term follow-up.Surg Endosc14612616CrossRefPubMedGoogle Scholar
  155. 155.
    Poulin, EC,  et al. 1999Laparoscopic resection does not adversely affect early survival curves in patients undergoing surgery for colorectal adenocarcinoma.Ann Surg229487492CrossRefPubMedGoogle Scholar
  156. 156.
    Schwenk, W,  et al. 1998Laparoscopic versus conventional colorectal resection: a prospective randomised study of postoperative ileus and early postoperative feeding.Langenbecks Arch Surg3834955CrossRefPubMedGoogle Scholar
  157. 157.
    Delgado, F,  et al. 1999Laparoscopic colorectal cancer resection: initial follow-up results.Surg Laparosc Endosc Percutan Tech99198CrossRefPubMedGoogle Scholar
  158. 158.
    Cook, TA, Dehn, TC 1996Port-site metastases in patients undergoing laparoscopy for gastrointestinal malignancy.Br J Surg8314191420CrossRefPubMedGoogle Scholar
  159. 159.
    Hoffman, GC,  et al. 1996Minimally invasive surgery for colorectal cancer: initial follow-up.Ann Surg223790796discussion 796798CrossRefPubMedGoogle Scholar
  160. 160.
    Molenaar, CB, Bijnen, AB, Ruiter, P 1998Indications for laparoscopic colorectal surgery. results from the Medical Centre Alkmaar, The Netherlands.Surg Endosc124245CrossRefPubMedGoogle Scholar
  161. 161.
    Quattlebaum, JK,Jr, Flanders, HD, Usher, CH 1993Laparoscopically assisted colectomy.Surg Laparosc Endosc38187PubMedGoogle Scholar
  162. 162.
    Ballantyne, GH 1995Laparoscopic-assisted colorectal surgery: review of results in 752 patients.Gastroenterologist37589PubMedGoogle Scholar
  163. 163.
    Fleshman, JW,  et al. 1996Early results of laparoscopic surgery for colorectal cancer: retrospective analysis of 372 patients treated by Clinical Outcomes of Surgical Therapy (COST) Study Group.Dis Colon Rectum39S53S58PubMedGoogle Scholar
  164. 164.
    Rosato P, et al. (1998) Port-site and wound metastases following laparoscopic resection of colorectal carcinoma: the experience of the Italian registry. Presented at the 33rd Congress of the European Society for Surgical Research (ESSR)Google Scholar
  165. 165.
    Vukasin, P,  et al. 1996Wound recurrence following laparoscopic colon cancer resection: results of the American Society of Colon and Rectal Surgeons Laparoscopic Registry.Dis Colon Rectum39S20S23PubMedGoogle Scholar
  166. 166.
    Gellman, L, Salky, B, Edye, M 1996Laparoscopic assisted colectomy.Surg Endosc1010411044CrossRefPubMedGoogle Scholar
  167. 167.
    Kok, KY,  et al. 1996Laparoscopic-assisted large bowel resection.Ann Acad Med Singapore25650652PubMedGoogle Scholar
  168. 168.
    Guillou, PJ, Darzi, A, Monson, JR 1993Experience with laparoscopic colorectal surgery for malignant disease.Surg Oncol24349CrossRefGoogle Scholar
  169. 169.
    Croce, E,  et al. 1997Laparoscopic colectomy: the absolute need for a standard operative technique.Jsls1217224PubMedGoogle Scholar
  170. 170.
    Kawamura, YJ,  et al. 1995Laparoscopic-assisted colectomy and lymphadenectomy without peritoneal insufflation for sigmoid colon cancer patients.Dis Colon Rectum38550552PubMedGoogle Scholar
  171. 171.
    Alexander, RJ, Jaques, BC, Mitchell, KG 1993Laparoscopically assisted colectomy and wound recurrence.Lancet341249250CrossRefGoogle Scholar
  172. 172.
    O‘Rourke, N,  et al. 1993Tumor inoculation during laparoscopy.Lancet342368CrossRefGoogle Scholar
  173. 173.
    Walsh, DC, Wattchow, DA, Wilson, TG 1993Subcutaneous metastases after laparoscopic resection of malignancy.Aust N Z J Surg63563565PubMedGoogle Scholar
  174. 174.
    Fusco, MA, Paluzzi, MW 1993Abdominal wall recurrence after laparoscopic-assisted colectomy for adenocarcinoma of the colon: report of a case.Dis Colon Rectum36858861PubMedGoogle Scholar
  175. 175.
    Cirocco, WC, Schwartzman, A, Golub, RW 1994Abdominal wall recurrence after laparoscopic colectomy for colon cancer.Surgery116842846PubMedGoogle Scholar
  176. 176.
    Nduka, CC,  et al. 1994Abdominal wall metastases following laparoscopy.Br J Surg81648652PubMedGoogle Scholar
  177. 177.
    Champault, G,  et al. 1994[Neoplastic colonization of trocart paths: should laparoscopic surgery be stopped for digestive cancers?Presse Med231313Google Scholar
  178. 178.
    Ramos, JM,  et al. 1994Laparoscopy and colon cancer: is the port site at risk? A preliminary report.Arch Surg129897899 discussion 900PubMedGoogle Scholar
  179. 179.
    Cohen, SM, Wexner, SD 1993Laparoscopic colorectal resection for cancer: the Cleveland Clinic Florida experience.Surg Oncol23542CrossRefPubMedGoogle Scholar
  180. 180.
    Jacquet, P,  et al. 1995Cancer recurrence following laparoscopic colectomy: report of two patients treated with neated intraperitoneal chemotherapy.Dis Colon Rectum3811101114PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • R. Veldkamp
    • 1
  • M. Gholghesaei
    • 1
  • H. J. Bonjer
    • 1
  • D. W. Meijer
    • 1
  • M. Buunen
    • 1
  • J. Jeekel
    • 1
  • B. Anderberg
    • 2
  • M. A. Cuesta
    • 3
  • A. Cuschierl
    • 4
  • A. Fingerhut
    • 5
  • J. W. Fleshman
    • 6
  • P. J. Guillou
    • 7
  • E. Haglind
    • 8
  • J. Himpens
    • 9
  • C. A. Jacobi
    • 10
  • J. J. Jakimowicz
    • 1
  • F. Koeckerling
    • 11
  • A. M. Lacy
    • 12
  • E. Lezoche
    • 13
  • J. R. Monson
    • 14
  • M. Morino
    • 15
  • E. Neugebauer
    • 16
  • S. D. Wexner
    • 17
  • R. L. Whelan
    • 18
  1. 1.Department of General SurgeryErasmus MCRotterdamThe Netherlands
  2. 2.Department of SurgeryUniversity of LinköpingSweden
  3. 3.Department of SurgeryVU Medical CenterAmsterdamThe Netherlands
  4. 4.University Department of SurgeryNinewells Hospital and Medical SchoolDundeeUnited Kingdom
  5. 5.Department of SurgeryCentre Hospitalier IntercommunalPolssyFrance
  6. 6.Division of General SurgeryWashington UniversitySt. LouisUSA
  7. 7.Academic Surgical UnitSt. James’s University HospitalLeedsUnited Kingdom
  8. 8.Department of SurgerySahlgrenska University HospitalGoteborgSweden
  9. 9.Department of Thoracic, Abdominal, and Minimally Invasive SurgerySaint Blasius General HospitalDendermondeBelgium
  10. 10.Department of SurgeryHumboldt University of BerlinBerlinGermany
  11. 11.Department of Surgery and Center for Minimally Invasive SurgeryHannover HospitalHannoverGermany
  12. 12.Department of SurgeryHospital Clinic i ProvincialBarcelonaSpain
  13. 13.Department of SurgeryUniversity of RomeRomeItaly
  14. 14.Academic Surgical UnitThe University of Hull, Castle Hill HospitalCottinghamUnited Kingdom
  15. 15.Department of SurgeryUniversity of TurinTurinItaly
  16. 16.Biochemical and Experimental Division, 2nd Department of SurgeryUniversity of CologneCologneGermany
  17. 17.Department of Colorectal SurgeryCleveland Clinic FloridaWestonUSA
  18. 18.Section of Colon and Rectal SurgeryColumbia University College of Physicians and SurgeonsNew YorkUSA

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