Have we improved in laparoscopic resection of rectal cancer: critical reflection on the early outcomes of COLOR II study

Jacob et al. reported the first series of a combination of laparoscopic colonic & rectal resections in 1991 (1). It took just over a decade of debate and several trials to prove that laparoscopic colonic surgery (LCS) unequivocally results in better short-term outcomes when compared to open colonic surgery (OCS) (2). Several randomised controlled trials (RCTs) (3-5) have demonstrated that LCS offers reduced intra-operative blood loss, length of incision, post-operative analgesia requirements as well as shorter hospital stay. In malignant resections, LCS also offers comparable clearance margins and lymph node harvest. Therefore, LCS is now a well-accepted alternative to open surgery (2). However, the debate involving the role of laparoscopic approach in rectal cancer resection continues and is far from over (6).