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Functional Recovery After Open Versus Laparoscopic Colonic Resection: A Randomized, Blinded Study

Published on Mar 1, 2005in Annals of Surgery9.476
· DOI :10.1097/01.sla.0000154149.85506.36
Linda Basse11
Estimated H-index: 11
,
Dorthe Hjort Jakobsen6
Estimated H-index: 6
+ 5 AuthorsHenrik Kehlet107
Estimated H-index: 107
Abstract
Open colonic resection is usually associated with a hospital stay of about 6 to 11 days and a complication rate of 15% to 20%.1–6 Introduction of laparoscopic-assisted colonic resection has reduced the hospital stay to about 4 to 8 days, with the same or a slightly lower morbidity rate in randomized trials.1–6 Concomitant with these technical developments, an increased body of evidence has been developed to demonstrate that perioperative care regimens, including optimized pain relief, early oral feeding, and mobilization, have profound effects to improve postoperative recovery and outcome.7,8 These so-called multimodal rehabilitation programs or fast-track surgery7,8 have been applied after laparoscopic9,10 and open11 colonic resection, resulting in reduced hospital stay to about 2 to 3 days. Unfortunately, assessment of laparoscopic versus open colonic resection on early postoperative outcome in randomized studies1–6 has not included a revision of postoperative care principles adjusted to recent scientific data,7,8 and therefore the difference between laparoscopic and open colonic resection on early postoperative recovery remains to be determined. Such studies require an optimized regimen and observer-blinded regimen to minimize treatment bias due to expected benefits of minimal invasive surgery or other new surgical techniques.12 The aim of this study was therefore to assess the functional recovery after laparoscopic-assisted versus open colonic resection, where both groups received a multimodal rehabilitation program in a randomized observer and patient-blinded design, and with planned discharge after 48 hours.
  • References (29)
  • Citations (380)
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References29
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#1Ka Lau Leung (CUHK: The Chinese University of Hong Kong)H-Index: 18
#2Samuel P. Y. Kwok (United Christian Hospital)H-Index: 2
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Summary Background Although laparoscopic resection of colorectal carcinoma improves post-operative recovery, long-term survival and disease control are the determining factors for its application. We aimed to test the null hypothesis that there was no difference in survival after laparoscopic and open resection for rectosigmoid cancer. Methods From Sept 21, 1993, to Oct 21, 2002, 403 patients with rectosigmoid carcinoma were randomised to receive either laparoscopic assisted (n=203) or conventio...
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Background: There has been no randomized clinical trial of the costs of laparoscopic colonic resection (LCR) compared with those of open colonic resection (OCR) in the treatment of colonic cancer. Methods: A subset of Swedish patients included in the Colon Cancer Open Or Laparoscopic Resection (COLOR) trial was included in a prospective cost analysis; costs were calculated up to 12 weeks after surgery. All relevant costs to society were included. No effects of the procedures, such as quality of ...
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