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Laparoscopic-assisted colectomy

Laparoscopic-assisted colectomyTHE QUESTION For patients with colon cancer, is laparoscopic- assisted surgery preferable to traditional, open-colon surgery?

PAST STUDIES of laparoscopic-assisted colectomy (LAC) have rarely focused on patients who were being treated for cancer, have assessed only the short-term effects of this minimally invasive technique and have involved only small numbers of patients.

THIS STUDY compared the physical and mental state of 428 patients two days, two weeks and two months after LAC or open surgery. On average, patients who underwent laparoscopic-assisted colectomy stayed in the hospital almost one day less and needed less pain medication while hospitalized than those who had open surgery. The authors considered these benefits minimal. The two groups had similar experiences regarding factors such as nausea, insomnia and fatigue.

WHO MAY BE AFFECTED BY THESE FINDINGS? People with localized colon cancer.

CAVEATS The researchers did not assess the patients’ need for pain relief after their discharge from the hospital. More important, this study did not compare the survival rates of the two groups of patients. (This issue is being evaluated using data from these and other patients, but the results will not be known for several years.)

BOTTOM LINE People with localized colon cancer may wish to refrain from asking doctors for laparoscopic-assisted colectomy until more is known about its risks and benefits. And as an editorial accompanying the study suggests, those who nonetheless prefer LAC may wish to consider entering a clinical trial to help establish the effectiveness and safety of the technique.

FIND THIS STUDY Issue of the Journal of the American Medical Association.

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