Systematic review on the short‐term outcome of laparoscopic resection for colon and rectosigmoid cancer

Tjandra, Joe J.; Chan, Miranda K. Y.

doi:10.1111/j.1463-1318.2006.00974.x

Cited by 221 publications

(163 citation statements)

References 81 publications

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“…Laparoscopically assisted surgery demonstrates improvements in outcome measures, including length of primary hospital stay and morbidity. 25 Laparoscopic resectional surgery is currently considered to be the key interventional change in traditional care that has led to improvements in recovery rates and reductions in morbidity following colorectal surgery. RCTs have demonstrated a reduction in primary length of hospital stay in association with laparoscopic colorectal surgery.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of enhanced recovery protocols in colorectal surgery

Rawlinson

Kang

Evans

et al. 2011

annals

139

103

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INTRODUCTION Colorectal surgery has been associated with a complication rate of 15-20% and mean postoperative inpatient stays of 6-11 days. The principles of enhanced recovery after surgery (ERAS) are well established and have been developed to optimise perioperative care and facilitate discharge. The purpose of this systematic review is to present an updated review of perioperative care in colorectal surgery from the available evidence and ERAS group recommendations. METHODS Systematic searches of the PubMed and Embase ™ databases and the Cochrane library were conducted. A hand search of bibliographies of identified studies was conducted to identify any additional articles missed by the initial search strategy. RESULTS A total of 59 relevant studies were identified. These included six randomised controlled trials and seven clinical controlled trials that fulfilled the inclusion criteria. These studies showed reductions in duration of inpatient stays in the ERAS groups compared with more traditional care as well as reductions in morbidity and mortality rates. CONCLUSIONS Reviewing the data reveals that ERAS protocols have a role in reducing postoperative morbidity and result in an accelerated recovery following colorectal surgery. Similarly, both primary and overall hospital stays are reduced significantly. However, the available evidence suggests that ERAS protocols do not reduce hospital readmissions or mortality. These findings help to confirm that ERAS protocols should now be implemented as the standard approach for perioperative care in colorectal surgery.

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Section: Discussionmentioning

confidence: 99%

A systematic review of enhanced recovery protocols in colorectal surgery

Rawlinson

Kang

Evans

et al. 2011

annals

139

103

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“…More recent data from large series (single institutions with over 100 patients and multi-institution series with over 400 patients), however, showed that the wound recurrence rate was in reality between 0 and 2.4%, somewhat comparable to what had been reported in open colectomy, ranging from 0.9 to 3.3% [35,78,87,[90][91][92] . At least five prospective randomized trials have shown that the incidence of wound recurrence was not a major issue [27,31,33,36,44] .…”

Section: Surgical Site or Port-site Recurrencesmentioning

confidence: 99%

Laparoscopic Approach to Colonic Cancer: Critical Appraisal of the Literature

Fingerhut

Ata²,

Chouillard³

et al. 2007

Dig Dis

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Background/Aims: As laparoscopic colectomy finds its place in the surgical armamentarium, the literature concerning the safety, efficacy, and oncological rational for treatment of colonic cancer is also enriched. A review and critical appraisal of the literature on this subject was the aim of this paper. Methods: A systematic research and a hand search were conducted to gain access to all controlled studies involving laparoscopic colectomy using the Medline, Embase, HealthSTAR, Cumulative Index for Nursing and Allied Health Literature, CancerLit data bases and the Cochrane Central Register of Controlled Trials for the years 1991–2006. Results: Over 40 controlled randomized trials and ten systematic reviews and/or meta-analyses were found. Several of the completed controlled randomized trials have published either short- or long-term results; only partial and short-term results are available in rectal cancer. The principal conclusions are that the laparoscopic approach affords better short-term outcomes including surgical site morbidity, but with increased operative times and direct costs. Among the proven long-term outcomes, cancer recurrence and survival do not seem to be worse. Whether conversion, a source of increased operative time and costs, is responsible for poorer outcomes or whether specific settings associated with poorer outcomes are among the causes of conversion remains to be shown. However, there are still concerns as regards specific laparoscopic-related complications. Conclusion: There seems to no real safety problems in performing laparoscopic colectomy for cancer; improvement in operative times, conversion rates, and complications should make laparoscopy the best cost-effective approach to colectomy.

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“…Prospective randomized studies and systematic reviews have demonstrated the advantages of laparoscopic over open colectomy for elective surgery [1][2][3][4][5]. Despite these advantages, there are few data evaluating laparoscopy for emergency colorectal procedures and there is skepticism regarding potential benefits [6].…”

Section: Introductionmentioning

confidence: 99%