***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: BACKGROUND : Meta-analyses of r and omized controlled trials support the use of laparoscopically assisted resection for colon cancer . The evidence supporting its use in rectal cancer is weak . OBJECTIVE : The purpose of this work was to investigate the uptake of laparoscopically assisted resection for colon and rectal cancer and to compare short- and long-term outcomes using population data . DESIGN : This was a retrospective cohort study using linked administrative health data . SETTING S : The study encompassed all of the public and private hospitals in New South Wales , Australia , between 2000 and 2008 . PATIENTS : A total of 27,947 patients with colon or rectal cancer undergoing surgery with curative intent were included in the study . MAIN OUTCOME MEASURES : We summarized the proportion of resections performed laparoscopically . Short-term outcomes were extended stay , 28-day readmission , 28-day emergency readmission , 30- and 90-day mortality , and 90-day readmission with pulmonary embolism or deep-vein thrombosis . Long-term outcomes were all-cause and cancer-specific death and admission with obstruction or incisional hernia repair . RESULTS : Laparoscopic procedures increased between 2000 and 2008 for colon ( 1.5%–20.7 % ) and rectal cancer ( 0.6%–15.5 % ) . Laparoscopic procedures reduced rates of extended stay ( OR , 0.60 ; 95 % CI , 0.49–0.72 ) and 28-day readmission ( OR , 0.86 ; 95 % CI , 0.74–0.99 ) for colon cancer . For rectal cancer , laparoscopic procedures had lower rates of 28-day readmission ( OR , 0.58 ; 95 % CI , 0.42–0.78 ) and 28-day emergency readmission ( OR , 0.54 ; 95 % CI , 0.34–0.85 ) . Laparoscopic procedures  improved cancer-specific survival for rectal cancer ( HR , 0.71 ; 95 % CI , 0.51–1.00 ) . Survival benefits were observed for laparoscopically assisted colon resection in higher-caseload hospitals but not lower-caseload hospitals . LIMITATIONS : It was not possible to identify laparoscopically assisted resections converted to open procedures because of the cl aims -based nature of the data . CONCLUSIONS : Despite increases in laparoscopically assisted resections for colon and rectal cancer , the majority of resections are still treated by open procedures . Our data suggest that laparoscopic resection reduces the lengths of stay and rates of readmission and may result in improved cancer-specific survival for both colon and rectal resections Background : Complete mesocolic excision ( CME ) and a high ( apical ) vascular tie may improve oncologic outcome after surgery for colon cancer . Our primary aim was to emulate a previous national result of 73.8 % overall survival ( OS ) with both the open and laparoscopic techniques . Methods : A prospect i ve study of radical colon cancer was initiated in a Norwegian community teaching hospital in 2007 and comprised a consecutive group of 251 patients with TNM stages I-III that had surgery according to the CME principle . Oncological outcome was assessed as OS , disease-free survival ( DFS ) and cancer-specific survival ( CSS ) , as well as time to recurrence ( TTR ) , using Cox regression analysis . Results : In-hospital mortality was 3.6 % , 2.3 % for laparoscopic surgery and 4.9 % for open management . Significantly more patients in the open CME group developed complications in the short term ( p < 0.001 ) . Twelve or more lymph nodes were retrieved from 82.9 % ( 208/251 ) of the specimens . Overall 3-year OS was 84.5 % , DFS 77.4 % , CSS 91.5 % and TTR 86.8 % . The surgical approach was not a significant predictor for any of the survival parameters . Conclusions : There was no survival difference between open and laparoscopic CME colonic resections , and the present OS improved from a previous OS from 2000 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-colectomy group ( two-sided P=0.32 ; hazard ratio for recurrence , 0.86 ; 95 percent confidence interval , 0.63 to 1.17 ) . Recurrence rates in surgical wounds were less than 1 percent in both groups ( P=0.50 ) . The overall survival rate at three years was also very similar in the two groups ( 86 percent in the laparoscopic-surgery group and 85 percent in the open-colectomy group ; P=0.51 ; hazard ratio for death in the laparoscopic-surgery group , 0.91 ; 95 percent confidence interval , 0.68 to 1.21 ) , with no significant difference between groups in the time to recurrence or overall survival for patients with any stage of cancer . Perioperative recovery was faster in the laparoscopic-surgery group than in the open-colectomy group , as reflected by a shorter median hospital stay ( five days vs. six days , P<0.001 ) and briefer use of parenteral narcotics ( three days vs. four days , P<0.001 ) and oral analgesics ( one day vs. two days , P=0.02 ) . The rates of intraoperative complications , 30-day postoperative mortality , complications at discharge and 60 days , hospital readmission , and reoperation were very similar between groups . CONCLUSIONS In this multi-institutional study , the rates of recurrent cancer were similar after laparoscopically assisted colectomy and open colectomy , suggesting that the laparoscopic approach is an acceptable alternative to open surgery for colon cancer Background and aims Evidence demonstrating improved short-term outcomes with laparoscopic surgery compared with open surgery for colorectal cancer is accumulating . In addition , programmes optimising peri-operative care for major abdominal surgery are becoming widespread . Evaluating laparoscopic surgery and enhanced recovery programmes usually focuses on short-term recovery . The aim of this study was to compare recovery after laparoscopic and open surgery for colorectal cancer up to 1 year post-operatively , using a combination of self-report and observer data . Patients / Methods From January 2002 to March 2004 , 62 patients were r and omised ( 2:1 ) to receive laparoscopic ( n = 43 ) or open surgery ( n = 19 ) within an enhanced recovery programme .  Functional outcomes up to 1 year were assessed using interview-administered question naires . Results / Findings Question naire and health-related quality of life data were obtained in over 85 % of patients . Patients undergoing laparoscopic surgery  felt fully recovered and resumed driving more quickly than those having open surgery ( p = 0.016 and p = 0.048 respectively ) . Fifty-eight percent of patients having open surgery felt fully recovered by 12 months versus 88 % of laparoscopic patients .Interpretation/ Conclusion Within an enhanced recovery programme , patients undergoing laparoscopic surgery  recovered more quickly than after open resection . Both approaches however , were associated with slow recovery despite a relatively short hospital stay BACKGROUND The safety and short-term benefits of laparoscopic colectomy for cancer remain debatable . The multicentre COLOR ( COlon cancer Laparoscopic or Open Resection ) trial was done to assess the safety and benefit of laparoscopic resection compared with open resection for curative treatment of patients with cancer of the right or left colon . METHODS 627 patients were r and omly assigned to laparoscopic surgery and 621 patients to open surgery .  The primary endpoint was cancer-free survival 3 years after surgery . Secondary outcomes were short-term morbidity and mortality , number of positive resection margins , local recurrence , port-site or wound-site recurrence , metastasis , overall survival , and blood loss during surgery . Analysis was by intention to treat . Here , clinical characteristics , operative findings , and postoperative outcome are reported . FINDINGS Patients assigned laparoscopic resection had less blood loss compared with those assigned open resection ( median 100 mL [ range 0 - 2700 ] vs 175 mL [ 0 - 2000 ] , p<0.0001 ) , although laparoscopic surgery lasted 30 min longer than did open surgery ( p<0.0001 ) . Conversion to open surgery was needed for 91 ( 17 % ) patients undergoing the laparoscopic procedure . Radicality of resection as assessed by number of removed lymph nodes and length of resected oral and aboral bowel did not differ between groups . Laparoscopic colectomy was associated with earlier recovery of bowel function ( p<0.0001 ) , need for fewer analgesics , and with a shorter hospital stay ( p<0.0001 ) compared with open colectomy .  Morbidity and mortality 28 days after colectomy did not differ between groups . INTERPRETATION Laparoscopic surgery can be used for safe and radical resection of cancer in the right , left , and sigmoid colon Background : We compared the perioperative parameters and outcomes achieved with h and -assisted laparoscopic colectomy ( HALC ) vs open colectomy ( OC ) for the management of benign and malignant colorectal disease , including cancer patients treated with curative intent . Methods : Sixty eligible patients were r and omized to either HALC ( n = 30 ) or OC ( n = 30 ) treatment groups . We used Pearson ’s chi-square and two- sample t-tests to compare the differences in demographics and perioperative parameters . Results : There were no significant differences in age , gender distribution , disease pattern , operative procedure , comorbidity , or history of abdominal surgery . The HALC patients had significantly shorter hospital stays and incision lengths , faster recovery of gastrointestinal function , less analgesic use and blood loss , and lower pain scores on postoperative days 1 , 3 , and 14 . There were no significant differences in operative time , complications , or time to return to normal activity . Conclusion : H and -assisted laparoscopic colectomy ( HALC ) is safe and produces better therapeutic results in terms of perioperative parameters than OC OBJECTIVE The quality of surgery  with D3 resection  in r and omized controlled clinical trial [ Japan Clinical Oncology Group study ( JCOG0404 ) ] was assessed by evaluation of the photo documentation of both open and laparoscopic surgeries . METHODS A multi-institutional r and omized-controlled trial ( JCOG0404 ) was conducted to evaluate open and laparoscopic D3 resection ( complete mesocolic excision + ligation and dissection at the root of the main vessels ) for Stage II/III colon cancer ( UMIN-CTR number C000000105 ) . A total of 1057 ( open , 528 ; laparoscopic , 529 ) eligible patients were enrolled . For quality control , it was ensured that the surgeries were performed by accredited surgeons , and a central committee review ed each surgery on the basis of the su bmi tted photographs of the resected field , specimen and skin incision . RESULTS For right-sided tumors , the rate of D3 resection  was 98.5 % ( 131/133 ) in the open arm and 100 % ( 136/136 ) in the laparoscopic arm , and for left-sided tumors , they were 97.9 % ( 322/329 ) and 98.2 % ( 320/326 ) , respectively . Sufficient length of the resected longitudinal margin was ensured in all cases . The skin incisions made in all the cases were < 8 cm as defined in the protocol in laparoscopic arm . CONCLUSIONS Completion of high quality surgery with D3 resection  was confirmed in JCOG0404 by central peer review of photographs of the surgical procedures in addition to operator regulations . This study suggests that the central review of the photo documentation is one of the important tools to assure a quality control of surgical technique in the Phase III r and omized-controlled study Objective : The aim of this study was to compare the long-term outcome of laparoscopy-assisted colectomy ( LAC )  and  open colectomy ( OC ) for nonmetastatic colon cancer . Methods : From November 1993 to July 1998 all patients with adenocarcinoma of the colon were assessed for entry in this single center , clinical ly r and omized trial . 
    Output:
    
CONCLUSION The laparoscopic approach offers the same quality of the resected specimen as the open approach in complete mesocolic excision with central vascular ligation for colon cancer .
The laparoscopic complete mesocolic excision with central vascular ligation is superior in all perioperative results and at least non-inferior in long-term oncological outcomes