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

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.