title: Short-term outcomes from a prospective randomized trial comparing laparoscopic and open surgery for colorectal cancer.
abstract: BACKGROUND
  Randomized trials in low-risk populations have failed to show any benefit for laparoscopic compared with open colorectal resection in terms of morbidity. Furthermore, it is not known whether laparoscopic colorectal resection would yield advantages if randomization were revealed during surgery after a diagnostic laparoscopy.
  
  
  METHODS
  Patients with cancer of the colon or upper rectum were randomly assigned to laparoscopic or open resection. All patients underwent diagnostic laparoscopy to assess whether laparoscopic resection was feasible and the result of randomization was then revealed to the surgeon. Main endpoints were overall, general and surgical morbidity, and mortality.
  
  
  RESULTS
  Some 679 patients underwent diagnostic laparoscopy which led to the exclusion of 207; 250 patients were allocated to laparoscopic and 222 to open resection. Conversion to laparotomy occurred in 28 patients (11.2 per cent). There were no differences in morbidity (overall 25.2 versus 23.9 per cent) or mortality (1.2 versus 0.9 per cent) between laparoscopic and open groups. Postoperative hospital stay was shorter after laparoscopic resection (median (range) 10 (1-123) versus 12 (4-109) days; P = 0.032).
  
  
  CONCLUSIONS
  Laparoscopic resection of colorectal cancer is associated with increased operating time but does not decrease morbidity even in a moderate-risk population.
authors.affiliation: Universitätsklinik für Allgemein-, Visceral-, Gefäss- und Thoraxchirurgie, Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Neudecker
authors.forename: F
authors.initials: F
authors.lastname: Klein
authors.forename: R
authors.initials: R
authors.lastname: Bittner
authors.forename: T
authors.initials: T
authors.lastname: Carus
authors.forename: A
authors.initials: A
authors.lastname: Stroux
authors.forename: W
authors.initials: W
authors.lastname: Schwenk
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D010535:Laparoscopy / Q000401:mortality / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome