Keyhole and open surgery for colourectal cancer both have proven
benefits but the fastest time recovery appears to be coming from
enhanced recovery after surgery programs, researchers say.
Laparoscopic, or keyhole, surgery has been the gold
standard for gall bladder operations for a few decades but it has had a
slower uptake in colourectal treatment, a study says.
Researchers analysed data on elective resections for
colourectal cancer from 2000 to 2008 and noticed a rise in laparoscopic
surgery from about 2.4 per cent to 27.5 per cent in Australia.
Lead author of the study published in the Medical Journal
of Australia, Bridie Thompson of The University of Queensland, says
that for rectal cancer, the increase was from 1.1 per cent to 21.5 per
cent during that time.
"Impetus for the increased uptake of laparoscopic surgery
for CRC comes not just from good quality evidence from randomised
trials and recommendations by medical bodies, but also from the positive
experiences of surgeons and their patients in everyday clinical
practice," Ms Thompson said.
Commenting on the study, Associate Professor Ned Abraham
of the University of New South Wales, said the short-term advantages of
keyhole surgery for colourectal cancer had proven benefits but they were
marginal.
People contemplating surgery should note that keyhole and
open surgery both have benefits, keyhole more for older patients, he
said.
"The message would be it doesn't really matter how the
surgery is done, as long as it is done properly, whether it is
laparoscopic or open," Prof Abraham said.
He suggested a multi-modal approach to rehabilitation,
such as the Enhanced Recovery After Surgery programs, may produce more
clinical benefits for patients and cost benefits for hospitals.
They begin before surgery and to optimise all aspects of
care and studies show fast recovery times with both open and keyhole
surgery.
Whether the laparoscopic approach could add to the benefits of a multi-modal approach has not been established, he said.
