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Related Experiment Videos

Functional recovery after open versus laparoscopic colonic resection: a randomized, blinded study.

Linda Basse1, Dorthe Hjort Jakobsen, Linda Bardram

  • 1Department of Surgical Gastroenterology, Copenhagen University Hospital, Hvidovre, Kettegaard Allé 30, DK-2650 Hvidovre, Denmark.

Annals of Surgery
|February 25, 2005
PubMed
Summary

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Multimodal rehabilitation (fast-track surgery) enables rapid functional recovery after laparoscopic or open colonic resection. This study found no significant differences in recovery times or morbidity between the two surgical approaches.

Area of Science:

  • Colorectal Surgery
  • Surgical Rehabilitation
  • Minimally Invasive Surgery

Background:

  • Multimodal rehabilitation, or fast-track surgery, enhances recovery and shortens hospital stays for both laparoscopic and open colonic surgery.
  • The comparative effectiveness of laparoscopy versus open surgery within a fast-track protocol remains unclear due to a lack of data.

Purpose of the Study:

  • To compare the functional recovery and outcomes of laparoscopic versus open colonic resection when both are combined with a multimodal rehabilitation (fast-track) approach.
  • To evaluate the specific benefits of laparoscopy in the context of enhanced recovery protocols.

Main Methods:

  • A randomized, observer-and-patient-blinded trial involving 60 patients (median age 75 years) undergoing elective laparoscopic or open colonic resection.

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  • Patients received fast-track rehabilitation with a planned 48-hour discharge; functional recovery was meticulously assessed for one month post-operation.

    • Main Results:

    • Both laparoscopic and open colonic resection groups experienced a median postoperative hospital stay of 2 days.
    • Functional recovery, including mobilization, pulmonary function, cardiovascular response, pain, sleep, fatigue, and gastrointestinal function, was similar and rapid in both groups.
    • No significant differences were observed in postoperative morbidity or readmissions, though mortality occurred in the open surgery group (3 patients) but not the laparoscopic group.

    Conclusions:

    • Multimodal rehabilitation significantly accelerates functional recovery after colonic resection, irrespective of surgical approach (laparoscopic or open).
    • Current data suggest no significant differences in functional recovery or general morbidity between laparoscopic and open colonic resection within a fast-track program.
    • Further extensive research is warranted to ascertain potential disparities in severe morbidity and mortality between the two surgical techniques.