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Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery: a randomized clinical trial (LAFA-study). / Vlug, Malaika S.; Wind, Jan; Hollmann, Markus W.; Ubbink, Dirk T.; Cense, Huib A.; Engel, Alexander F.; Gerhards, Michael F.; van Wagensveld, Bart A.; van der Zaag, Edwin S.; van Geloven, Anna A. W.; Sprangers, Mirjam A. G.; Cuesta, Miguel A.; Bemelman, Willem A.; AUTHOR GROUP.

In: Annals of surgery, Vol. 254, No. 6, 2011, p. 868-875.

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Vlug, Malaika S. ; Wind, Jan ; Hollmann, Markus W. ; Ubbink, Dirk T. ; Cense, Huib A. ; Engel, Alexander F. ; Gerhards, Michael F. ; van Wagensveld, Bart A. ; van der Zaag, Edwin S. ; van Geloven, Anna A. W. ; Sprangers, Mirjam A. G. ; Cuesta, Miguel A. ; Bemelman, Willem A. ; AUTHOR GROUP. / Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery: a randomized clinical trial (LAFA-study). In: Annals of surgery. 2011 ; Vol. 254, No. 6. pp. 868-875.

BibTeX

@article{cfd65093df2741a5a9508be8c714c871,
title = "Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery: a randomized clinical trial (LAFA-study)",
abstract = "To investigate which perioperative treatment, ie, laparoscopic or open surgery combined with fast track (FT) or standard care, is the optimal approach for patients undergoing segmental resection for colon cancer. Important developments in elective colorectal surgery are the introduction of laparoscopy and implementation of FT care, both focusing on faster recovery. In a 9-center trial, patients eligible for segmental colectomy were randomized to laparoscopic or open colectomy, and to FT or standard care, resulting in 4 treatment groups. Primary outcome was total postoperative hospital stay (THS). Secondary outcomes were postoperative hospital stay (PHS), morbidity, reoperation rate, readmission rate, in-hospital mortality, quality of life at 2 and 4 weeks, patient satisfaction and in-hospital costs. Four hundred patients were required to find a minimum difference of 1 day in hospital stay. Median THS in the laparoscopic/FT group was 5 (interquar-tile range: 4-8) days; open/FT 7 (5-11) days; laparoscopic/standard 6 (4.5-9.5) days, and open/standard 7 (6-13) days (P < 0.001). Median PHS in the laparoscopic/FT group was 5 (4-7) days; open/FT 6 (4.5-10) days; laparoscopic/standard 6 (4-8.5) days and open/standard 7 (6-10.5) days (P < 0.001). Secondary outcomes did not differ significantly among the groups. Regression analysis showed that laparoscopy was the only independent predictive factor to reduce hospital stay and morbidity. Optimal perioperative treatment for patients requiring segmental colectomy for colon cancer is laparoscopic resection embedded in a FT program. If open surgery is applied, it is preferentially done in FT care. This study was registered under NTR222 (www.trialregister.nl)",
author = "Vlug, {Malaika S.} and Jan Wind and Hollmann, {Markus W.} and Ubbink, {Dirk T.} and Cense, {Huib A.} and Engel, {Alexander F.} and Gerhards, {Michael F.} and {van Wagensveld}, {Bart A.} and {van der Zaag}, {Edwin S.} and {van Geloven}, {Anna A. W.} and Sprangers, {Mirjam A. G.} and Cuesta, {Miguel A.} and Bemelman, {Willem A.} and {AUTHOR GROUP} and Benedikt Preckel and Patrick Bossuyt and Dirk Gouma and {van Berge Henegouwen}, Mark and Jan Fuhring and {van Lenthe}, {Ineke Picard} and Chris Bakker and Bellinda King-Kalimanis and Jan Hofland and Cornelis Dejong and {van Dam}, Ronald and {van der Peet}, Donald and {van Zalingen}, Edith and Astrid Noordhuis and {de Jong}, Dick and Goei, {T. Hauwy} and {de Stoppelaar}, Erica and {van den Dongen}, Marjon and {van Tets}, Willem and {van den Elsen}, Maarten and Annemiek Swart and Laurens deWit and Muriel Siepel and Glaresa Molly and Jan Juttmann and Wilfred Clevers and Andrea Bieleman and Ludo Coenen and Elly Bonekamp and {van Abeelen}, Jacobus and {van Iterson-de Jong}, Diana and Margriet Krombeen",
year = "2011",
doi = "10.1097/SLA.0b013e31821fd1ce",
language = "English",
volume = "254",
pages = "868--875",
journal = "Annals of surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

RIS

TY - JOUR

T1 - Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery: a randomized clinical trial (LAFA-study)

AU - Vlug, Malaika S.

AU - Wind, Jan

AU - Hollmann, Markus W.

AU - Ubbink, Dirk T.

AU - Cense, Huib A.

AU - Engel, Alexander F.

AU - Gerhards, Michael F.

AU - van Wagensveld, Bart A.

AU - van der Zaag, Edwin S.

AU - van Geloven, Anna A. W.

AU - Sprangers, Mirjam A. G.

AU - Cuesta, Miguel A.

AU - Bemelman, Willem A.

AU - AUTHOR GROUP

AU - Preckel, Benedikt

AU - Bossuyt, Patrick

AU - Gouma, Dirk

AU - van Berge Henegouwen, Mark

AU - Fuhring, Jan

AU - van Lenthe, Ineke Picard

AU - Bakker, Chris

AU - King-Kalimanis, Bellinda

AU - Hofland, Jan

AU - Dejong, Cornelis

AU - van Dam, Ronald

AU - van der Peet, Donald

AU - van Zalingen, Edith

AU - Noordhuis, Astrid

AU - de Jong, Dick

AU - Goei, T. Hauwy

AU - de Stoppelaar, Erica

AU - van den Dongen, Marjon

AU - van Tets, Willem

AU - van den Elsen, Maarten

AU - Swart, Annemiek

AU - deWit, Laurens

AU - Siepel, Muriel

AU - Molly, Glaresa

AU - Juttmann, Jan

AU - Clevers, Wilfred

AU - Bieleman, Andrea

AU - Coenen, Ludo

AU - Bonekamp, Elly

AU - van Abeelen, Jacobus

AU - van Iterson-de Jong, Diana

AU - Krombeen, Margriet

PY - 2011

Y1 - 2011

N2 - To investigate which perioperative treatment, ie, laparoscopic or open surgery combined with fast track (FT) or standard care, is the optimal approach for patients undergoing segmental resection for colon cancer. Important developments in elective colorectal surgery are the introduction of laparoscopy and implementation of FT care, both focusing on faster recovery. In a 9-center trial, patients eligible for segmental colectomy were randomized to laparoscopic or open colectomy, and to FT or standard care, resulting in 4 treatment groups. Primary outcome was total postoperative hospital stay (THS). Secondary outcomes were postoperative hospital stay (PHS), morbidity, reoperation rate, readmission rate, in-hospital mortality, quality of life at 2 and 4 weeks, patient satisfaction and in-hospital costs. Four hundred patients were required to find a minimum difference of 1 day in hospital stay. Median THS in the laparoscopic/FT group was 5 (interquar-tile range: 4-8) days; open/FT 7 (5-11) days; laparoscopic/standard 6 (4.5-9.5) days, and open/standard 7 (6-13) days (P < 0.001). Median PHS in the laparoscopic/FT group was 5 (4-7) days; open/FT 6 (4.5-10) days; laparoscopic/standard 6 (4-8.5) days and open/standard 7 (6-10.5) days (P < 0.001). Secondary outcomes did not differ significantly among the groups. Regression analysis showed that laparoscopy was the only independent predictive factor to reduce hospital stay and morbidity. Optimal perioperative treatment for patients requiring segmental colectomy for colon cancer is laparoscopic resection embedded in a FT program. If open surgery is applied, it is preferentially done in FT care. This study was registered under NTR222 (www.trialregister.nl)

AB - To investigate which perioperative treatment, ie, laparoscopic or open surgery combined with fast track (FT) or standard care, is the optimal approach for patients undergoing segmental resection for colon cancer. Important developments in elective colorectal surgery are the introduction of laparoscopy and implementation of FT care, both focusing on faster recovery. In a 9-center trial, patients eligible for segmental colectomy were randomized to laparoscopic or open colectomy, and to FT or standard care, resulting in 4 treatment groups. Primary outcome was total postoperative hospital stay (THS). Secondary outcomes were postoperative hospital stay (PHS), morbidity, reoperation rate, readmission rate, in-hospital mortality, quality of life at 2 and 4 weeks, patient satisfaction and in-hospital costs. Four hundred patients were required to find a minimum difference of 1 day in hospital stay. Median THS in the laparoscopic/FT group was 5 (interquar-tile range: 4-8) days; open/FT 7 (5-11) days; laparoscopic/standard 6 (4.5-9.5) days, and open/standard 7 (6-13) days (P < 0.001). Median PHS in the laparoscopic/FT group was 5 (4-7) days; open/FT 6 (4.5-10) days; laparoscopic/standard 6 (4-8.5) days and open/standard 7 (6-10.5) days (P < 0.001). Secondary outcomes did not differ significantly among the groups. Regression analysis showed that laparoscopy was the only independent predictive factor to reduce hospital stay and morbidity. Optimal perioperative treatment for patients requiring segmental colectomy for colon cancer is laparoscopic resection embedded in a FT program. If open surgery is applied, it is preferentially done in FT care. This study was registered under NTR222 (www.trialregister.nl)

U2 - 10.1097/SLA.0b013e31821fd1ce

DO - 10.1097/SLA.0b013e31821fd1ce

M3 - Article

C2 - 21597360

VL - 254

SP - 868

EP - 875

JO - Annals of surgery

JF - Annals of surgery

SN - 0003-4932

IS - 6

ER -

ID: 1442004