Is laparoscopic colorectal surgery less invasive than classical open surgery? Quantitation of physical activity using an accelerometer to assess postoperative convalescence.
BACKGROUND
With the technical advances of recent years, the number of operative manipulations in the abdominal cavity by laparoscopic surgery is now considered to be the same as that using classical open surgery. The question has been raised whether laparoscopic colorectal surgery with lymphadenectomy improves the recovery compared to open surgery.


METHODS
We compared patients' physical activity for 7 days postoperatively as measured with an accelerometer between laparoscopic-assisted colorectal resection (LAC, n = 32) and classical open colorectal surgery (OC, n = 30).


RESULTS
Physical activity expressed as cumulative acceleration was significantly higher in the LAC than in the OC group on each postoperative day. The recovery time, defined as the day on which the cumulative acceleration recovered to 90% of the preoperative level, was significantly shorter (p < 0.05) in the LAC (3.4 +/- 1.2 days) than in the OC group (6.8 +/- 1.7 days).


CONCLUSIONS
Our results showed that the duration of convalescence with LAC was significantly shorter than that with the OC procedure. Laparoscopic colorectal surgery appears to allow an earlier recovery after the operation than the classical open procedure, and it is less invasive as assessed by convalescence.
Inoue
Y
Y
Department of Surgery, Nissay Hospital, 6-3-8 Itachibori, Nishi-Ku, Osaka City, Osaka 550-0012, Japan. zeninoue@vivajpn.com
Kimura
T
T
Noro
H
H
Yoshikawa
M
M
Nomura
M
M
Yumiba
T
T
Taniguchi
E
E
Ohashi
S
S
Souda
S
S
Matsuda
H
H
D000054:Acceleration; D000368:Aged; D015179:Colorectal Neoplasms / Q000601:surgery*; D003289:Convalescence; D003672:Defecation; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D007813:Laparotomy / Q000009:adverse effects*; D007902:Length of Stay; D008197:Lymph Node Excision / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D009043:Motor Activity; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology; D011184:Postoperative Period; D020127:Recovery of Function; D016896:Treatment Outcome; D016138:Walking