This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Short‐term outcomes from a prospective randomized trial comparing laparoscopic and open surgery for colorectal cancer. BJS 2009; 96: 1458-1467.
Published: 13th November 2009
Authors: J. Neudecker, F. Klein, R. Bittner, T. Carus, A. Stroux, W. Schwenk et al.
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.
Method
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).
Conclusion
Laparoscopic resection of colorectal cancer is associated with increased operating time but does not decrease morbidity even in a moderate‐risk population. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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