Abstract
Aim
To investigate the rate of laparoscopic colectomies for colon cancer using registries
and population-based studies. To provide a position paper on mini-invasive (MIS) colon
cancer surgery based on the opinion of experts leader in this field.
Methods
A systematic review of the literature was conducted using PRISMA guidelines for the
rate of laparoscopy in colon cancer. Moreover, Delphi methodology was used to reach
consensus among 35 international experts in four study rounds. Consensus was defined
as an agreement ≥75.0%. Domains of interest included nosology, essential technical/oncological
requirements, outcomes and MIS training.
Results
Forty-four studies from 42 articles were reviewed. Although it is still sub-optimal,
the rate of MIS for colon cancer increased over the years and it is currently >50%
in Korea, Netherlands, UK and Australia. The remaining European countries are un-investigated
and presented lower rates with highest variations, ranging 7–35%. Using Delphi methodology,
a laparoscopic colectomy was defined as a “colon resection performed using key-hole
surgery independently from the type of anastomosis”. The panel defined also the oncological
requirements recognized essential for the procedure and agreed that when performed
by experienced surgeons, it should be marked as best practice in guidelines, given
the principles of oncologic surgery be respected (R0 procedure, vessel ligation and
mesocolon integrity).
Conclusion
The rate of MIS colectomies for cancer in Europe should be further investigated. A
panel of leaders in this field defined laparoscopic colectomy as a best practice procedure
when performed by an experienced surgeon respecting the standards of surgical oncology.
Keywords
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Article info
Publication history
Published online: February 04, 2018
Accepted:
January 16,
2018
Identification
Copyright
© 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
