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
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)
📖 Papers frequently viewed together
12 Authors (R. Veldkamp, ..., Antonio M. Lacy)
1,484 Citations
467 Citations
841 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
#1B. DoussetH-Index: 39
#2Ph. de MestierH-Index: 28
Last. Corinne VonsH-Index: 30
view all 3 authors...
926 CitationsSource
#1Ka Lau Leung (CUHK: The Chinese University of Hong Kong)H-Index: 18
#2Samuel P. Y. Kwok (United Christian Hospital)H-Index: 2
Last. W. Y. Lau (CUHK: The Chinese University of Hong Kong)H-Index: 55
view all 8 authors...
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...
735 CitationsSource
#1Martin Janson (KI: Karolinska Institutet)H-Index: 11
#2Ingela Björholt (Sahlgrenska University Hospital)H-Index: 11
Last. Bo Anderberg (KI: Karolinska Institutet)H-Index: 18
view all 7 authors...
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 ...
169 CitationsSource
#1Linda Basse (UCPH: University of Copenhagen)H-Index: 11
#2Jens Erik ThorbølH-Index: 1
Last. Henrik Kehlet (UCPH: University of Copenhagen)H-Index: 107
view all 4 authors...
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
346 CitationsSource
#1A. D. G. AndersonH-Index: 9
#2Clare McNaughtH-Index: 10
Last. C. J. MitchellH-Index: 16
view all 6 authors...
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...
295 CitationsSource
#1Linda Basse (Copenhagen University Hospital)H-Index: 11
#2Jan L. Madsen (Copenhagen University Hospital)H-Index: 12
Last. Henrik Kehlet (Copenhagen University Hospital)H-Index: 107
view all 5 authors...
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...
53 CitationsSource
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...
912 CitationsSource
#1Conor P. Delaney (Cleveland Clinic)H-Index: 62
#2Massarat ZutshiH-Index: 20
Last. Victor W. Fazio MbH-Index: 98
view all 6 authors...
399 CitationsSource
#1Conor P. Delaney (Cleveland Clinic)H-Index: 62
#2Ravi P. Kiran (Cleveland Clinic)H-Index: 40
Last. Victor W. Fazio Mb (Cleveland Clinic)H-Index: 98
view all 5 authors...
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
210 CitationsSource
#1Anthony J. Senagore (Cleveland Clinic)H-Index: 57
#2Hans J. Duepree (Cleveland Clinic)H-Index: 10
Last. Victor W. Fazio Mb (Cleveland Clinic)H-Index: 98
view all 5 authors...
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...
130 CitationsSource
Cited By380
#1Shanping Ye (NCU: Nanchang University)
#2Jun Shi (NCU: Nanchang University)H-Index: 3
Last. Taiyuan Li (NCU: Nanchang University)H-Index: 2
view all 10 authors...
Reports in the field of robotic surgery for gastric cancer are increasing. However, studies only on patients with advanced gastric cancer (AGC) are lacking. This retrospective study was to compare the short-term outcomes of robotic-assisted distal gastrectomy (RADG) and laparoscopic-assisted distal gastrectomy (LADG) with D2 lymphadenectomy for AGC. From December 2014 to November 2019, 683 consecutive patients with AGC underwent mini-invasive assisted distal gastrectomy. Propensity-score matchin...
#1Magdalena Pisarska (Jagiellonian University Medical College)H-Index: 11
#2Grzegorz Torbicz (Jagiellonian University Medical College)H-Index: 4
Last. Michał Pędziwiatr (Jagiellonian University Medical College)H-Index: 14
view all 9 authors...
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.
3 CitationsSource
#1Yu-Lin Guo (Capital Medical University)
#2Feng Cao (Capital Medical University)H-Index: 5
Last. Fei Li (Capital Medical University)H-Index: 9
view all 7 authors...
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 ...
#1Simon BergmanH-Index: 20
#2Laura DrudiH-Index: 9
#1Guillaume Martel (U of O: University of Ottawa)H-Index: 15
#2Robin P. Boushey (U of O: University of Ottawa)H-Index: 17
Last. Peter W. Marcello (Lahey Hospital & Medical Center)H-Index: 34
view all 3 authors...
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...
#1Joanne Lee (Royal Derby Hospital)H-Index: 2
#2Viren Asher (Royal Derby Hospital)H-Index: 8
Last. Anish Bali (Royal Derby Hospital)H-Index: 8
view all 7 authors...
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.
#1Basile Pache (UNIL: University of Lausanne)H-Index: 6
#2Fabian Grass (UNIL: University of Lausanne)H-Index: 14
Last. Dieter Hahnloser (UNIL: University of Lausanne)H-Index: 30
view all 6 authors...
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.
3 CitationsSource
#1James W.F. CattoH-Index: 54
#2Pramit Khetrapal (UCL: University College London)H-Index: 6
Last. John D. Kelly (UCL: University College London)H-Index: 29
view all 15 authors...
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...
5 CitationsSource
#1Jisun Lee (Asan Medical Center)H-Index: 1
#2Eunji Seo (Asan Medical Center)H-Index: 1
Last. Ja Min (Asan Medical Center)H-Index: 1
view all 4 authors...
2 CitationsSource