PROSPECTIVE RANDOMIZED STUDY OF LAPAROSCOPIC VERSUS OPEN COLONIC RESECTION FOR ADENOCARCINOMA

Background Laparoscopic techniques have been evaluated for many operat ions, but retrospective and prospective studies have failed to show th ese techniques to be superior to open operations in all patients with colorectal disease. This study compares laparoscopic and open colonic resection in a randomized fashion with special reference to outcome, c omplications and immunomodulation. Methods The clinical course, assess ment of convalescence parameters, immunofunction and pathological eval uation of the operative specimen were compared in 34 patients with col onic adenocarcinoma. The patients were randomized to either laparoscop ic surgery (group 1, n = 18) or open surgery (group 2, n = 16). As fiv e patients were excluded the number of patients was 15 in group 1 and 14 in group 2. Results Patients in group 1 were discharged earlier (P < 0.05) and suffered less pain (P < 0.01 at rest, P < 0.05 during coug hing and mobilization). Surgery was equally radical in the two groups. Intraoperative bleeding, postoperative reduction in pulmonary functio n, and level of fatigue were identical in the two groups. The immunode pression was more pronounced in patients in group (P < 0.01). Conclusi on Laparoscopic colonic resection is an acceptable and safe alternativ e to open procedures; the differences between the two techniques are n ot marked.