Can the combination of laparoscopy and enhanced recovery improve long-term survival after elective colorectal cancer surgery?

N. J. Curtis, M. Taylor, Lorna K. Fraser, E. Salib, E. Noble, R. Hipkiss, A. S. Allison, R. Dalton, J. B. Ockrim, Nader K. Francis

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Aim: Enhanced recovery after surgery (ERAS) programmes and laparoscopic techniques both provide short-term benefits to patients undergoing colorectal cancer surgery. ERAS protocol compliance may improve long-term survival in those undergoing open colorectal resection but as laparoscopic data has not been reported. Therefore, we aimed to investigate the impact of the combination of laparoscopy and ERAS management on 5-year overall survival. 

Methods: A dedicated prospectively populated colorectal cancer surgery database was reviewed. Patient inclusion criteria were biopsy-proven colorectal adenocarcinoma, undergoing elective surgery undertaken with curative intent. All patients were managed within an established ERAS programme and routinely followed up for 5 years. Overall survival was measured using the log-rank Kaplan-Meier method at 5 years. 

Results: Eight hundred fifty-four patients met the inclusion criteria. Four hundred eighty-one (56%) cases were laparoscopic with 98 patients (20%) requiring conversion. There were no differences in patient or tumour demographics between the surgical groups. Median ERAS protocol compliance was 93% (range 53–100%). Five-year overall survival was superior in laparoscopic cases compared with that of converted and open surgery (78 vs 68 vs 70%, respectively, p < 0.007). An open approach (HR 1.55, 95%CI 1.16–2.06, p = 0.002) and delayed hospital discharge (> 7 days, HR 1.5, 95%CI 1.13–1.9, p = 0.003) were the only modifiable risk factors associated with poor survival. 

Conclusions: The use of a laparoscopic approach with enhanced recovery after surgery management appears to have long-term survival benefits following colorectal cancer resection.

Original languageEnglish
Pages (from-to)231-234
Number of pages4
JournalInternational Journal of Colorectal Disease
Volume33
Issue number2
Early online date29 Nov 2017
DOIs
Publication statusPublished - 1 Feb 2018

Keywords

  • Enhanced recovery
  • ERAS
  • Laparoscopy
  • Long term
  • Survival

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint

Dive into the research topics of 'Can the combination of laparoscopy and enhanced recovery improve long-term survival after elective colorectal cancer surgery?'. Together they form a unique fingerprint.

Cite this