Laparoscopic colonic surgery has been claimed to hasten recovery and reduce hospital stay compared with open operation.
Recently, enforced multimodal rehabilitation (fast-track surgery) has improved recovery and reduced hospital stay in both laparoscopic and open colonic surgery.
Since no comparative data between laparoscopic and open colonic resection with multimodal rehabilitation are available, the value of laparoscopy per se is unknown.
Dr Basse and colleagues conducted a randomized, blinded trial in 60 patients (median age 75 years) who underwent elective laparoscopic or open colonic resection with fast-track rehabilitation and planned discharge after 48 hours.
The researchers assessed functional recovery in detail during the first postoperative month.
|There were no significant differences in postoperative mortality or readmissions in the open versus laparoscopic group
|Annals of Surgery|
The median postoperative hospital stay was 2 days in both groups.
The research team assessed early and similar recovery to normal activities by hours of mobilization per day and computerized monitoring of motor activity.
In addition, the researchers assessed recovery by pulmonary function, cardiovascular response to treadmill exercise, pain, sleep quality, fatigue, and return to normal gastrointestinal function.
The team found no significant differences in postoperative morbidity, mortality, or readmissions, although 3 patients died in the open versus none in the laparoscopic group.
Dr Basse concluded, “Functional recovery after colonic resection is rapid with a multimodal rehabilitation regimen and without differences between open and laparoscopic operation.”
“Further large-scale studies are required on potential differences in serious morbidity and mortality.”