Role of minimally invasive surgery for rectal cancer

• Published in: World journal of gastroenterology : WJG Vol. 26; no. 30; pp. 4394 - 4414
• Main Authors: Melstrom, Kurt A, Kaiser, Andreas M
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 14.08.2020
• Subjects: Digestive System Surgical Procedures; Humans; Laparoscopy - adverse effects; Minimally Invasive Surgical Procedures; Minireviews; Proctectomy; Rectal Neoplasms - surgery; Robotic Surgical Procedures - adverse effects; Transanal Endoscopic Surgery; Robotic surgery; Laparoscopic surgery; Minimally invasive surgery; Rectal cancer; Transanal minimally invasive surgery; Transanal total mesorectal excision
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/WJG.V26.I30.4394

Rectal cancer is one of the most common malignancies worldwide. Surgical resection for rectal cancer usually requires a proctectomy with respective lymphadenectomy (total mesorectal excision). This has traditionally been performed transabdominally through an open incision. Over the last thirty years, minimally invasive surgery platforms have rapidly evolved with the goal to accomplish the same quality rectal resection through a less invasive approach. There are currently three resective modalities that complement the traditional open operation: (1) Laparoscopic surgery; (2) Robotic surgery; and (3) Transanal total mesorectal excision. In addition, there are several platforms to carry out transluminal local excisions (without lymphadenectomy). Evidence on the various modalities is of mixed to moderate quality. It is unreasonable to expect a randomized comparison of all options in a single trial. This review aims at reviewing in detail the various techniques in regard to intra-/perioperative benchmarks, recovery and complications, oncological and functional outcomes.