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

Linda Basse·Dorthe Hjort Jakobsen·Linda Bardram·Per Billesbølle·Claus Lund·Torben Mogensen·Jacob Rosenberg·Henrik Kehlet
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Abstract

BACKGROUND: 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. METHODS: In a randomized, observer-and-patient, blinded trial, 60 patients (median age 75 years) underwent elective laparoscopic or open colonic resection with fast-track rehabilitation and planned discharge after 48 hours. Functional recovery was assessed in detail during the first postoperative month. RESULTS: Median postoperative hospital stay was 2 days in both groups, with early and similar recovery to normal activities as assessed by hours of mobilization per day, computerized monitoring of motor activity assessed, pulmonary function, cardiovascular response to treadmill exercise, pain, sleep quality, fatigue, and return to normal gastrointestinal function. There were no significant differences in postoperative morbidity, mortality, or readmissions, although 3 patients died in the open versus nil in the laparoscopic group. CONCLUSION: 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.

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Activities of Daily LivingAgedAged, 80 and overColectomyDouble-Blind MethodFemaleHemodynamicsHumansLaparoscopyLength of StayMaleMiddle AgedPostoperative PainPatient SatisfactionPostoperative ComplicationsRecovery of FunctionRespiratory MechanicsClinical TrialJournal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov't

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Linda Basse, Dorthe Hjort Jakobsen, Linda Bardram, Per Billesbølle, Claus Lund, Torben Mogensen, Jacob Rosenberg, Henrik Kehlet. 2005. Functional recovery after open versus laparoscopic colonic resection: a randomized, blinded study.. https://doi.org/10.1097/01.sla.0000154149.85506.36

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