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

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.