Detailed evaluation of functional recovery following laparoscopic or open surgery for colorectal cancer within an enhanced recovery programme
Detailed evaluation of functional recovery following laparoscopic or open surgery for colorectal cancer within an enhanced recovery programme
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DOI：
10.1007/s00384-008-0478-0
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发表时间：
2008-08-01
影响因子：
2.8
通讯作者：
Kennedy, R. H.
中科院分区：
文献类型：
--
作者：
King, P. M.;Blazeby, J. M.;Kennedy, R. H.
背景和目的越来越多的证据表明，腹腔镜手术治疗结直肠癌的短期疗效优于开腹手术。此外，优化腹部大手术围手术期护理的方案也越来越普遍。评估腹腔镜手术和增强恢复计划通常侧重于短期恢复。本研究的目的是比较恢复后腹腔镜手术和开放手术结直肠癌术后1年，使用自报和观察者data.Patients/方法相结合，从2002年1月至2004年3月，62例患者随机（2：1）接受腹腔镜手术（n=43）或开放手术（n=19）内增强恢复程序。功能结果长达1年进行了评估，使用访谈管理的questionnaire.Results/Findings问卷调查和健康相关的生活质量的数据，获得超过85%的患者。接受腹腔镜手术的患者感觉完全恢复，并且比接受开放手术的患者更快地恢复驾驶（分别为p=0.016和p=0.048）。58%的开放手术患者感觉完全恢复了12个月，而腹腔镜patients.Interpretation/结论的88%，在一个增强的恢复方案，腹腔镜手术的患者比开放切除术后恢复更快。然而，这两种方法尽管住院时间相对较短，但恢复缓慢。
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.