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

Published on Mar 1, 2005in Annals of Surgery9.48
· DOI :10.1097/01.sla.0000154149.85506.36
Linda Basse11
Estimated H-index: 11
,
Dorthe Hjort Jakobsen6
Estimated H-index: 6
+ 5 AuthorsHenrik Kehlet105
Estimated H-index: 105
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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 (27)
  • Citations (377)
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References27
Newest
Published on Apr 1, 2004in The Lancet59.10
Ka Lau Leung18
Estimated H-index: 18
(CUHK: The Chinese University of Hong Kong),
Samuel P.Y. Kwok2
Estimated H-index: 2
(United Christian Hospital)
+ 5 AuthorsWan Yee Lau23
Estimated H-index: 23
(CUHK: The Chinese University of Hong Kong)
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...
Published on Apr 1, 2004in British Journal of Surgery5.59
Martin Janson11
Estimated H-index: 11
(KI: Karolinska Institutet),
Ingela Björholt11
Estimated H-index: 11
(Sahlgrenska University Hospital)
+ 4 AuthorsBo Anderberg18
Estimated H-index: 18
(KI: Karolinska Institutet)
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 ...
Published on Mar 1, 2004in Diseases of The Colon & Rectum4.09
Linda Basse11
Estimated H-index: 11
(UCPH: University of Copenhagen),
Jens Erik Thorbøl1
Estimated H-index: 1
+ 1 AuthorsHenrik Kehlet105
Estimated H-index: 105
(UCPH: University of Copenhagen)
BACKGROUND:For patients undergoing colonic surgery, the postoperative hospital stay is usually 6 to 10 days, and the morbidity rate is 15 to 20 percent. Fast-track rehabilitation programs have reduced the hospital stay to 2 to 3 days. The aim of this study was to evaluate the postoperative outcome a
Published on Dec 1, 2003in British Journal of Surgery5.59
A. D. G. Anderson9
Estimated H-index: 9
,
Clare McNaught10
Estimated H-index: 10
+ 3 AuthorsC. J. Mitchell17
Estimated H-index: 17
Background: Multimodal optimization of surgical care has been associated with reduced hospital stay and improved physical function. The aim of this randomized trial was to compare multimodal optimization with standard care in patients undergoing colonic resection. Methods: Twenty-five patients requiring elective right or left hemicolectomy were randomized to receive a ten-point optimization programme (14 patients) or conventional care (11). The groups were similar in terms of age (64 versus 68 y...
Published on Dec 1, 2003in Surgical Endoscopy and Other Interventional Techniques3.21
Linda Basse11
Estimated H-index: 11
(Copenhagen University Hospital),
Jan L. Madsen12
Estimated H-index: 12
(Copenhagen University Hospital)
+ 2 AuthorsHenrik Kehlet105
Estimated H-index: 105
(Copenhagen University Hospital)
Background: Multimodal rehabilitation with epidural analgesia, early oral nutrition and mobilization, and laxative use has decreased the duration of ileus after colonic surgery to about 2 days, as compared with the usual 3 to 5 days of rehabilitation required after open surgery and the slightly shorter time required with laparoscopic surgery. Gastrointestinal transit after colonic resection with laparoscopy or laparotomy was assessed. Methods: In this study, 32 patients randomized to laparoscopi...
Published on Dec 1, 2003in The Lancet59.10
Henrik Kehlet105
Estimated H-index: 105
,
J. B. Dahl48
Estimated H-index: 48
The specialty of anaesthesia has seen major advances thanks to the development of safer anaesthetic agents, improved knowledge of pain physiology and pain management, and incorporation of a better understanding of perioperative pathophysiology into perioperative care. Concomitantly, development of minimally invasive surgery has further reduced stress responses and pain, thereby providing potential for enhanced recovery. However, an increasing proportion of elderly patients with organ dysfunction...
Published on Jul 1, 2003in Annals of Surgery9.48
Conor P. Delaney59
Estimated H-index: 59
(Cleveland Clinic),
Ravi P. Kiran39
Estimated H-index: 39
(Cleveland Clinic)
+ 2 AuthorsVictor W. Fazio Mb95
Estimated H-index: 95
(Cleveland Clinic)
ObjectiveComparison of outcome and costs after laparoscopic and open colectomy.Summary Background DataPrevious studies comparing laparoscopic and open colectomy report conflicting results with regard to clinical outcome and costs.MethodsLaparoscopic colectomy patients from a prospective database wer
Published on Jul 1, 2003in Diseases of The Colon & Rectum4.09
Conor P. Delaney59
Estimated H-index: 59
(Cleveland Clinic),
Massarat Zutshi20
Estimated H-index: 20
+ 3 AuthorsVictor W. Fazio Mb95
Estimated H-index: 95
INTRODUCTION: In an era of dwindling hospital resources and increasing medical costs, safe reduction in postoperative stay has become a major focus to optimize utilization of healthcare resources. Although several protocols have been reported to reduce postoperative stay, no Level I evidence exists for their use in routine clinical practice. METHODS: Sixty-four patients undergoing laparotomy and intestinal or rectal resection were randomly assigned to a pathway of controlled rehabilitation with ...
Published on Apr 1, 2003in Diseases of The Colon & Rectum4.09
Anthony J. Senagore55
Estimated H-index: 55
(Cleveland Clinic),
Hans J. Duepree10
Estimated H-index: 10
(Cleveland Clinic)
+ 2 AuthorsVictor W. Fazio Mb95
Estimated H-index: 95
(Cleveland Clinic)
INTRODUCTION: Laparoscopic sigmoid colectomy has been accepted slowly despite potential advantages because of the perceptions of a steep learning curve and increased operative times and costs. The purpose of this article is to review the outcome of a standardization of all the intraoperative and postoperative processes used in our department for the performance of laparoscopic sigmoid colectomy. METHODS: A consecutive series of patients requiring laparoscopic sigmoid colectomy from March 1999 th...
Cited By377
Newest
Published on Jul 8, 2019in World Journal of Surgery2.77
Magdalena Pisarska10
Estimated H-index: 10
(Jagiellonian University Medical College),
Grzegorz Torbicz3
Estimated H-index: 3
(Jagiellonian University Medical College)
+ 6 AuthorsMichał Pędziwiatr11
Estimated H-index: 11
(Jagiellonian University Medical College)
Introduction Enhanced recovery after surgery (ERAS) pathways have been proven to enhance postoperative recovery, reduce morbidity, and reduce length of hospital stay after colorectal cancer surgery. However, despite the benefits of the ERAS program on short-term results, little is known about its impact on long-term results.
Published on Feb 28, 2019in BioMed Research International2.20
Yulin Guo (Capital Medical University), Feng Cao4
Estimated H-index: 4
(Capital Medical University)
+ 4 AuthorsFei Li8
Estimated H-index: 8
(Capital Medical University)
Background. Laparoscopy has been widely applied in gastrointestinal surgery, with benefits such as less intraoperative blood loss, faster recovery, and shorter length of hospital stay. However, it remains controversial if laparoscopic major gastrointestinal surgery could be conducted for patients with chronic obstructive pulmonary disease (COPD) which was traditionally considered as an important risk factor for postoperative pulmonary complications. The present study was conducted to review and ...
Published on Dec 1, 2018in Seminars in Colon and Rectal Surgery
Guillaume Martel14
Estimated H-index: 14
(U of O: University of Ottawa),
Robin P. Boushey16
Estimated H-index: 16
(U of O: University of Ottawa),
Peter W. Marcello35
Estimated H-index: 35
(Lahey Hospital & Medical Center)
Concerns over the oncologic safety of laparoscopic colectomy for colorectal cancer have resulted in extensive comparisons with open surgery in the form of randomized trials. From the current review of the best available literature, we conclude that laparoscopic resection for colon cancer is associated with numerous short-term benefits, including decreased postoperative pain and analgesia requirements, speedier recovery of bowel function, shorter length of stay in hospital, and potentially a decr...
Published on Dec 1, 2018
Joanne Lee2
Estimated H-index: 2
(Royal Derby Hospital),
Viren Asher8
Estimated H-index: 8
(Royal Derby Hospital)
+ 4 AuthorsAnish Bali8
Estimated H-index: 8
(Royal Derby Hospital)
Background Enhanced recovery has been shown to improve patients’ experience after surgery. There are no previous studies comparing patients’ experience between those undergoing laparoscopic and open gynaecological surgery. Therefore, the aim of this prospective study is to compare patients’ functional recovery based on milestones set by the enhanced recovery programme and patients’ satisfaction between the two groups.
Published on Dec 1, 2018in International Journal of Colorectal Disease2.64
Basile Pache4
Estimated H-index: 4
(UNIL: University of Lausanne),
Fabian Grass11
Estimated H-index: 11
(UNIL: University of Lausanne)
+ 3 AuthorsDieter Hahnloser29
Estimated H-index: 29
(UNIL: University of Lausanne)
Introduction Training and teaching are cornerstones in developing surgical skills. The present study aimed to compare intraoperative outcomes of colonic resections among fellows, consultants, and supervised trainees.
Published on Aug 8, 2018in BMJ Open2.38
James Catto53
Estimated H-index: 53
,
Pramit Khetrapal5
Estimated H-index: 5
(UCL: University College London)
+ 12 AuthorsNorman R. Williams14
Estimated H-index: 14
(UCL: University College London)
INTRODUCTION: Bladder cancer (BC) is a common malignancy and one of the most expensive to manage. Radical cystectomy (RC) with pelvic lymphadenectomy is a gold standard treatment for high-risk BC. Reductions in morbidity and mortality from RC may be achieved through robot-assisted RC (RARC). Prospective comparisons between open RC (ORC) and RARC have been limited by sample size, use of extracorporeal reconstruction and use of outcomes important for ORC. Conversely, while RARC is gaining in popul...
Published on Jun 1, 2018in Clinical nutrition ESPEN
Marco Braga47
Estimated H-index: 47
(UniSR: Vita-Salute San Raffaele University),
Marco Scatizzi16
Estimated H-index: 16
+ 18 AuthorsMarco Azzola1
Estimated H-index: 1
Summary Background & aims The Enhanced Recovery After Surgery (ERAS) pathway represents an optimal approach in patients undergoing colorectal surgery but complexity in implementing its items could limit its application. The aim of this study is to identify possible core items within an ERAS pathway following elective colorectal resection. Methods This is a retrospective review of data prospectively collected between January 2014 and September 2015 by 14 Italian Hospitals in an electronic registr...
Published on Jun 1, 2018in Surgical Innovation1.47
Mesut Sipahi2
Estimated H-index: 2
,
Ergin Arslan3
Estimated H-index: 3
Purpose. Intracorporeal knot tying in laparoscopic surgery continues to be a problem especially for beginners and inexperienced surgeons. A wide-angle needle holder was designed to make the knot maneuver easier while also ensuring that the knot does not come out of the needle holder. In this study, it was planned to compare the wide-angle needle holder with the classic needle holder in regard to knot tying time. Material and method. A total of 11 male volunteers were randomly selected from fresh...
Published on Jan 1, 2018
Lawrence Lee19
Estimated H-index: 19
(MUHC: McGill University Health Centre),
Liane S. Feldman41
Estimated H-index: 41
(MUHC: McGill University Health Centre)
Perioperative care is a complex intervention. By minimizing surgical trauma, laparoscopy has been demonstrated to diminish the surgical stress response, decrease postoperative pain, hasten gastrointestinal function and return to independence, which have translated into improved clinical outcomes. But there are limitations in what surgical technique alone can achieve. Many other aspects of perioperative care play an important role in the surgical stress response and subsequent postoperative traje...
View next paperA clinical pathway to accelerate recovery after colonic resection.