Laparoscopy and colon cancers : the arguments for and against.

Are we entitled, in 2004, to propose laparoscopic colect omy forcancer? This question is licit if we consider three points whichmade or are still the object of controversies, namely: respect of theprinciples of an oncologic resection, risk of site port metastases,results in terms of recurrence and 5-year survival.Concerning the first two points, the first one is at present clarifiedand the second better clarified; as for the third the answer will begiven before some years at the conclusion of the analysis of prospectivemulticenter trials; but already intermediate results seem tobe encouraging. Arguments are thus more and more in favour oflaparoscopy applied to colon cancers, provided however that surgeonshave a perfect control of this approach, for which the prerequirednumber of procedures is estimated at 30. Therefore laparoscopiccolectomies should first be practiced for benign conditions,in this particular case diverticular disease and polyps of the colonnot resectable endoscopically.