***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction The field of  laparoscopic rectal cancer surgery  is exp and ing . We compare short-term and early oncological outcomes after laparoscopic versus open resection in carefully matched rectal cancer patients . Methods All consecutive patients undergoing elective laparoscopic resection for rectal cancer were review ed .  Laparoscopic resections were matched 1:1 to open resections by age , gender , American Society of Anesthesiologists class , body mass index , neoadjuvant chemoradiation , and type of surgery . Data were analyzed using Fisher ’s exact , chi-square , Wilcoxon rank-sum tests , and Kaplan – Meier estimates . P-value < 0.05 was considered statistically significant . Results Ninety-one rectal cancer patients with laparoscopic resection were included , 59 % were male , and median age was 62 years . Conversion rate was 18.7 % . Laparoscopic and open surgery had similar 30-day morbidity and mortality except wound infection , which was lower for the laparoscopic group ( p = 0.02 ) . Laparoscopic surgery had similar 30-day readmissions but shorter total length of hospital stay ( 5 versus 7 days , p < 0.01 ) , time to first flatus ( 3 versus 4.5 days , p = 0.001 ) , and time to first bowel movement ( 4 versus 5 days , p = 0.05 ) when compared with open surgery . The 3-year disease-free survival , local recurrence , and distant recurrence rates were also similar between the two groups . Conclusion Laparoscopic surgery can be safely performed for rectal cancer , with better postoperative recovery and acceptable early oncological outcomes . Results from large ongoing r and omized trials with longer follow-up time are pending to better define oncologic outcomes PURPOSE : To compare the outcome after laparoscopicversus open resection for colorectal adenocarcinoma . METHODS : A retrospective cohort analysis of all patients undergoing elective resection for colorectal adenocarcinoma between November 1992 and June 1999 at a university-affiliated hospital . These included 219 open ( mean age , 68.3 years ) and 98 laparoscopic ( mean age , 70.3 years ) resections . Data from converted cases ( n=12 ) were included in the laparoscopic group using the intention-to-treat principle . RESULTS : Operative time , lymph node yield , resection margins and postoperative morbidity and mortality were similar between laparoscopic and open technique . Parenteral analgesic use was less in the laparoscopic group ( laparoscopic , 2.7 ; open , 3.2 days;P=0.021 ) . Time to first flatus ( laparoscopic , 1.8 ; open , 3 days;P<0.0001 ) and first bowel movement ( laparoscopic , 3.5 ; open , 4.9 days;P<0.0001 ) was shorter in the laparoscopic group . Resumption of an oral liquid diet ( laparoscopic , 2.1 ; open , 4 days;P<0.0001 ) and solid diet ( laparoscopic , 5.2 ; open , 7.1 days;P<0.0001 ) was also quicker in the laparoscopic patients . Length of hospitalization was significantly shorter in the laparoscopic patients ( laparoscopic , 6.9 ; open , 10.9 days;P<0.001 ) . There were less minor complications in the laparoscopic group ( laparoscopic , 11.2 ; open , 21.5 percent;P=0.029 ) but no difference in major complications or perioperative mortality . Recurrence , disease-free and overall survival were similar between the two groups . No port site recurrences ocurred in the laparoscopic group but there were three wound recurrences in the open group . CONCLUSIONS : Laparoscopic resection for colorectal cancer can be performed safely and effectively in tertiary centers . Earlier discharge from hospital , quicker resumption of oral feeds and less postoperative pain are clear advantages . No adverse effect on recurrence or survival was noted , but results of prospect i ve , r and omized trials , currently underway , are needed before laparoscopic resection for colorectal cancer becomes the st and ard of practice Purpose sThis study aims to compare the perioperative outcomes and survival between  laparoscopic-assisted right hemicolectomy ( LARH ) and open right hemicolectomy ( ORH ) for right-sided colon cancer . Methods Between July 1996 and October 2005 , 145 patients were r and omized to receive LARH ( n = 71 ) or ORH ( n = 74 ) . Results The median follow-up of living patients was 99.7 months . The demographic data of the two groups were similar . The time to resume diet ( 4 vs. 5 days , p = 0.045 ) and the hospital stay ( 7.8 vs. 10 days , p = 0.033 ) were significantly shorter in LARH group , but these benefits were at the expense of longer operating time ( 198 vs. 129 min , p = 0.002 ) and higher direct cost ( USD8745 vs. USD6293 , p < 0.001 ) . The morbidity and mortality were comparable between the two groups . After curative resection , the probabilities of survival at 5 years of the LARH and ORH groups were 74.2 % ( SE 7.4 % ) and 75 % ( SE 7.1 % ) , respectively . The probabilities of being disease free at 5 years were 82.3 % ( SE 6.9 % ) and 84.1 % ( SE 6.2 % ) , respectively . Conclusions Laparoscopic-assisted resection of right-sided colonic cancer has the advantage over open surgery in allowing earlier recovery . However this is at the expense of a longer operating time and higher direct cost ( registration number : NCT00485316 ( http://www . clinical trials.gov ) ) Open colostomy reversal carries significant rates of wound infection , anastomotic leak , and incisional hernia which often limit its acceptance . We hypothesized that the laparoscopic approach to the restoration of intestinal continuity may result in lower perioperative morbidity and faster postoperative recovery .  Twenty-two cases of laparoscopic colostomy reversals performed at a single institution were identified and compared to 22 r and omly selected open colostomy closures performed during the same time period . Patients were compared based on demographics , previous indications for colostomy procedures , and perioperative outcomes . A total of 152 patients underwent reversal of left-sided colostomies during the study period . The laparoscopic approach was successful in 20 of 22 cases ; there were 2 conversions to open ( 9 % ) secondary to inability to adequately mobilize the rectal stump . The laparoscopic and open groups were comparable based on mean age ( 54 years versus 49 years ; P=0.23 ) , BMI ( 26 kg/m2 versus 27 kg/m2 ; P=0.66 ) , gender ( 9 % males versus 13 % males ; P=0.23 ) , ASA Class ( 2.6 versus 2.3 ; P=0.07 ) , and history of previous intra-abdominal sepsis ( 17 versus 16 cases ) . Operative times were similar ( 158 versus 189 minutes ; P=0.16 ) , and estimated blood loss was significantly less in the laparoscopic group ( 113 versus 270 ml ; P=0.01 ) . No intraoperative complications occurred in the laparoscopic group and two enterotomies occurred in the open group . The laparoscopic group had earlier passage of flatus ( 3.5 versus 5.0 days ; P=0.001 ) and shorter hospitalization ( 4.2 versus 7.3 days ; P=0.001 ) . Perioperative complications occurred in 3 ( 14 % ) laparoscopic and 13 ( 59 % ) open cases ( P=0.01 ) . There was no mortality in this series . The laparoscopic approach can be safely used in the restoration of intestinal continuity . It results in a decreased perioperative morbidity and faster recovery , and it offers distinct advantages over the open approach to colostomy reversal Background Postoperative bowel obstruction caused by intra-abdominal adhesions occurs after all types of abdominal surgery . It has been suggested that the laparoscopic technique should reduce the risk for adhesion formation and thus for postoperative bowel obstruction . This study was design ed to compare the incidence of bowel obstruction in a r and omized trial where laparoscopic and open resection for colon cancer was compared . Methods A retrospective analysis was performed , collecting data of episodes of bowel obstruction with or without surgery . Only episodes treated in the hospital where the index surgery took place were included . Data for 786 patients were collected for the 5-year period after cancer surgery . Results Baseline characteristics for the evaluated laparoscopic ( n = 383 ) and open ( n = 403 ) groups were comparable . The cumulative obstruction percentages at 5 years for the open and laparoscopic groups were 6.5 and 5.1 % respectively and did not significantly differ from each other . Tumor stage seemed to influence the risk for bowel obstruction : 2.8 % in stage I , 6.6 % in stage II , and 7 % in stage III , but the differences were not significant . Conclusions This analysis does not support the hypothesis that laparoscopy leads to fewer episodes of bowel obstruction compared with open surgery This prospect i ve , r and omized study compared the outcomes of h and -assisted laparoscopic surgery ( HALS ) with open surgery for the resection of rectal cancer . The main outcome measures were procedure time , blood loss , post-operative pain , time to oral intake , return of bowel function , length of hospital stay , morbidity and functional recovery .  Patients in each group were similar with regard to general status , procedure types and the histopathological features of tumours .  Procedure times were significantly longer with HALS versus open surgery .  Analgesic requirements , surgical blood loss , time to first passing flatus , time to first oral fluids and postoperative hospital stay length were all significantly shorter in the HALS group . At a median follow-up of 16.3 months , local recurrence of tumour was not observed in either group . In this study , the HALS approach for curative resection of rectal cancer was safe and effective and may offer several potential advantages to patients in their post-operative recovery Background This Japanese multicenter retrospective study evaluated short- and long-term outcomes of palliative laparoscopic procedures for symptomatic stage IV colorectal cancer compared with conventional open procedures . Methods Of 968 eligible patients with stage IV colorectal cancer enrolled during January 2006–December 2007 from 41 participating surgical units ( Japan Society of Laparoscopic Colorectal Surgery Group ) , we studied 409 patients who underwent palliative resection of symptomatic primary colorectal tumor . Results Data from patients with laparoscopic resection ( n = 98 ) and open colorectal resection ( n = 311 ) were analyzed . Eleven ( 11.2 % ) laparoscopic operations were converted to an open procedure . Fewer complications were reported for laparoscopic resections than for open procedures ( 13.3 vs. 26.7 % ; p = 0.0042 ) . Postoperative hospital stay was significantly shorter in the laparoscopic vs. open resection group ( median , 14 vs. 17 days ; p = 0.0242 ) .  Postoperative chemotherapy treatment was administered to 245 ( 78.9 % ) patients in the open and 78 ( 79.6 % ) patients in the laparoscopic resection group . Time from surgery to start of postoperative chemotherapy was significantly shorter in the laparoscopic vs. open resection group ( median , 32 vs. 27 days ; p = 0.0487 ) . Median survival time between the two groups was not significantly different ( 22.0 vs. 22.2 months ; p = 0.948 ) . Conclusions Laparoscopic palliative resection results in reduced postoperative complications and earlier recovery with acceptable long-term outcomes comparable with open surgery . When performed by experienced surgeons in selected patients , it may be a safe and feasible option . Because of the potential of significant bias arising from the included studies , further r and omized controlled trials should be undertaken to confirm this bias BACKGROUND Minimally invasive , laparoscopically assisted surgery was first considered in 1990 for patients undergoing colectomy for cancer . Concern that this approach would compromise survival by failing to achieve a proper oncologic resection or adequate staging or by altering patterns of recurrence ( based on frequent reports of tumor recurrences within surgical wounds ) prompted a controlled trial evaluation . METHODS We conducted a noninferiority trial at 48 institutions and r and omly assigned 872 patients with adenocarcinoma of the colon to undergo open or laparoscopically assisted colectomy performed by credentialed surgeons . The median follow-up was 4.4 years . The primary end point was the time to tumor recurrence . RESULTS At three years , the rates of recurrence were similar in the two groups--16 percent among patients in the group that underwent laparoscopically assisted surgery and 18 percent among patients in the open-colect 
    Output:
    
The reduction in postoperative bowel obstruction demonstrates an advantage of laparoscopic surgery in patients with colorectal disease