Detailed evaluation of functional recovery following laparoscopic or open surgery for colorectal cancer within an enhanced recovery programme.
OBJECTIVE
Evidence demonstrating improved short-term outcomes with laparoscopic surgery compared with open surgery for colorectal cancer is accumulating. In addition, programmes optimising peri-operative care for major abdominal surgery are becoming widespread. Evaluating laparoscopic surgery and enhanced recovery programmes usually focuses on short-term recovery. The aim of this study was to compare recovery after laparoscopic and open surgery for colorectal cancer up to 1 year post-operatively, using a combination of self-report and observer data.


METHODS
From January 2002 to March 2004, 62 patients were randomised (2:1) to receive laparoscopic (n=43) or open surgery (n=19) within an enhanced recovery programme. Functional outcomes up to 1 year were assessed using interview-administered questionnaires.


RESULTS
Questionnaire and health-related quality of life data were obtained in over 85% of patients. Patients undergoing laparoscopic surgery felt fully recovered and resumed driving more quickly than those having open surgery (p=0.016 and p=0.048 respectively). Fifty-eight percent of patients having open surgery felt fully recovered by 12 months versus 88% of laparoscopic patients.


CONCLUSIONS
Within an enhanced recovery programme, patients undergoing laparoscopic surgery recovered more quickly than after open resection. Both approaches however, were associated with slow recovery despite a relatively short hospital stay.
King
P M
PM
Department of Surgery, Yeovil District Hospital, Yeovil, Somerset, BA21 4AT, UK. pmking@doctors.org.uk
Blazeby
J M
JM
Ewings
P
P
Kennedy
R H
RH
D000203:Activities of Daily Living; D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D001334:Automobile Driving; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011788:Quality of Life; D020127:Recovery of Function