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Detailed evaluation of functional recovery following laparoscopic or open surgery for colorectal cancer within an enhanced recovery programme

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aims

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.

Patients/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/Findings

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.

Interpretation/Conclusion

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.

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Author information

Authors and Affiliations

  1. Department of Surgery, Yeovil District Hospital, Yeovil, Somerset, BA21 4AT, UK

    P. M. King & R. H. Kennedy

  2. Departments of Social Medicine & Clinical Sciences at South Bristol, University of Bristol, Bristol, BS8 2PR, UK

    J. M. Blazeby

  3. Research and Development, Taunton and Somerset Hospital, Taunton, TA1 5DA, UK

    P. Ewings

  4. Specialist Registrar, General Surgery, Royal Cornwall Hospital, Truro, TR1 3LJ, UK

    P. M. King

Authors
  1. P. M. King
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  2. J. M. Blazeby
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  3. P. Ewings
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  4. R. H. Kennedy
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Corresponding author

Correspondence to P. M. King.

Additional information

This work was supported by an NHS Developments in the Organisation of Care Projects Grant. Yeovil District Hospital has received funds from Ethicon Endosurgery to support post-graduate training in laparoscopic surgery.

The short-term outcomes from this RCT have been published in the British Journal of Surgery in 2006 (Randomised clinical trial comparing laparoscopic and open surgery for colorectal cancer within an enhanced recovery programme. King PM, Blazeby JM, Ewings P, Franks PJ, Longman RJ, Kendrick AH, Kipling RM, Kennedy RH. Br J Surg 93(3):300–308, 2006 March).

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King, P.M., Blazeby, J.M., Ewings, P. et al. Detailed evaluation of functional recovery following laparoscopic or open surgery for colorectal cancer within an enhanced recovery programme. Int J Colorectal Dis 23, 795–800 (2008). https://doi.org/10.1007/s00384-008-0478-0

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  • DOI: https://doi.org/10.1007/s00384-008-0478-0

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