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Laparoscopic colorectal cancer surgery reduced length of hospital stay
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Patient-reported outcomes and physical fatigue were comparable between patients who underwent laparoscopic or conventional colorectal cancer surgery with an enhanced recovery program, but laparoscopic surgery significantly reduced the length of hospital stays, study results showed.
Robin H. Kennedy, MS, of St. Mark’s Hospital in Harrow, United Kingdom, and colleagues evaluated data from 204 patients with colorectal cancer who were suitable for elective resection.
Researchers stratified patients according to age, center and cancer site (colon vs. rectum). They randomly assigned patients to laparoscopic surgery (n=103) or conventional open surgery (n=101). Both arms included an enhanced recovery program with 30 possible interventions.
Physical fatigue served as the study’s primary endpoint. Secondary endpoints included length of hospital stay, complications, physical function and additional patient-reported outcomes.
The mean physical fatigue score 1 month after surgery was 12.28 among patients in the laparoscopic arm and 12.05 among patients who underwent conventional surgery (adjusted mean difference, –0.23; 95% CI, –1.52-1.07).
Patients in the laparacocopic and open surgery arms experienced similar rates of complications 30 days after surgery (31.7% vs. 35.6%; P=.55), and researchers observed no significant differences in independent pathological specimen assessments or in patient-reported outcomes.
However, the median total hospital stay was shorter among patients who underwent laparoscopic surgery (5 days vs. 7 days; P=.033).
“This emphasizes the general benefits of enhanced recovery care combined with expert surgery, whether it is laparoscopic or open in approach,” the researchers wrote. “Further study is needed to clarify whether the inability to demonstrate a difference in other outcomes was because of a lack of power or because the two interventions within an enhanced recovery program led to similar short-term recovery.”
Disclosure: The researchers report research funding from Ethicon Endo-Surgery, Medical Research Council UK and Olympus UK.
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