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The benefits of laparoscopy in benign diseases are quite clear. Patients generally can expect smaller incisions, less narcotic usage, quicker return of bowel function, and shorter hospitalizations. The benefits of laparoscopy in oncologic surgery are less clear, and laparoscopic oncology surgery has many critics. Early reports of long surgical times, high operating room costs, and alarming rates of port-site recurrences after laparoscopic colectomy for colorectal cancer all but stopped this less-invasive approach outside the confines of clinical protocols. As the results of larger retrospective studies began to refute these earlier detrimental claims, prospective randomized trials began to take a foothold. In this article, we review these randomized trials with particular attention to the perioperative effects of laparoscopic colectomy and the short-term oncologic outcomes.

The abuse of prescription opioids has been reported to be on the rise and has gained much public attention, especially given the recent media coverage devoted to the abuse of sustained-release oxycodone (OxyContin, Purdue Pharma LP, Stamford, CT). We tracked admissions to our substance abuse program to put OxyContin abuse into perspective as a presenting problem in the region. A total of 258 admissions to a psychiatric facility for opioid dependence over a 15 month period, for the treatment of prescription opioid abuse, were examined in this chart-review study. A total of 162 patients (62.8%) were admitted for problems related to OxyContin, and the remaining 96 (37.2%) were admitted for abusing other prescription opioids (not including OxyContin). Those abusing OxyContin were found to be younger, more often from a rural background, and more likely to be male compared with those abusing other prescription opioids. In addition, more than half met the criteria for an additional chemical dependency diagnosis and had an additional psychiatric diagnosis. Polysubstance abuse, including OxyContin abuse, was a significant presenting problem to our Addictive Disease Unit between October 2000 and December 2001. Although this chart-review study is not designed to be indicative of the epidemiology of OxyContin abuse, it offers some insight into the nature of this phenomenon in a particular region during the height of public attention paid to it. A follow-up prospective study to examine this phenomenon in multiple regions, further away chronologically from the increased media attention, is underway.