***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: CONTEXT Laparoscopic-assisted colectomy ( LAC ) has emerged as the preferred minimally invasive surgical strategy for diseases of the colon . The safety and efficacy of LAC for colon cancer are unknown , and the nature and magnitude of any quality -of-life ( QOL ) benefit result ing from LAC for colon cancer is also unknown . OBJECTIVE To compare short-term QOL outcomes after LAC vs open colectomy for colon cancer . DESIGN , SETTING , AND PARTICIPANTS Multicenter , r and omized controlled trial ( Clinical Outcomes of Surgical Therapy [ COST ] ) . Between September 1994 and February 1999 , 37 of 48 centers provided data for the QOL component of the trial for 449 consecutive patients with clinical ly resectable colon cancer . MAIN OUTCOME MEASURES Scores on the Symptoms Distress Scale ( SDS ) , Quality of Life Index , and a single-item global rating scale at 2 days , 2 weeks , and 2 months postoperative ; duration of postoperative in-hospital analgesic use ; and length of stay . RESULTS Of 449 patients , 428 provided QOL data . In an intention-to-treat analysis comparing SDS pain intensity , SDS summary , QOL Index summary , and global rating scale scores at each time point , the only statistically significant difference observed between groups was the global rating scale score for 2 weeks postsurgery . The mean ( median ) global rating scale scores for 2 weeks postsurgery were 76.9 ( 80 ) for LAC vs 74.4 ( 75 ) for open colectomy ( P = .009 ) . While in the hospital , patients assigned to LAC required fewer days of both parenteral analgesics compared with patients assigned to open colectomy ( mean [ median ] , 3.2 [ 3 ] vs 4.0 [ 4 ] days ; P<.001 ) and oral analgesics ( mean [ median ] , 1.9 [ 1 ] vs 2.2 [ 2 ] days ; P = .03 ) . CONCLUSION Only minimal short-term QOL benefits were found with LAC for colon cancer compared with st and ard open colectomy . Until ongoing trials establish that LAC is as effective as open colectomy in preventing recurrence and death from colon cancer , this procedure should not be offered to patients with colon cancer 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 The recent Anévrisme de l'aorte abdominale : Chirurgie versus Endoprothèse ( ACE ) study showed that open surgery of infrarenal abdominal aortic aneurysms ( AAAs ) provided very good results in patients with st and ard surgical risk , with good anatomic results for endovascular aneurysm repair ( EVAR ) . The goal of the current study was to show that aortic laparoscopy is a minimally invasive alternative to open surgery while avoiding the complications associated with laparotomy . METHODS From February 2002 to August 2010 , the authors performed 239 laparoscopic AAA repairs . A subgroup of 99 patients with st and ard surgical risk presented with AAAs compatible with EVAR . The evaluation criteria of surgical risk and anatomic criteria compatible with EVAR corresponded to those edicted by the Agence Française de Sécurité Sanitaire des Produits de Santé and the Haute Autorité de Santé . The patients ' data base was prospect i ve and the file analysis was retrospective . Digital data were given in median and extremes . RESULTS The patient age was 68 years ( range , 53 - 79 years ) . The aneurysmal diameter was 51 mm ( range , 45 - 69 mm ) . Surgery and clamping times were 210 min ( range , 180 - 520 min ) and 81 min ( range , 35 - 140 min ) , respectively . There were 60 aortic tubes and 39 bifurcated prostheses . Five patients ( 5 % ) required conversion . No hospital mortality occurred . Three patients presented with severe systemic complications ( 3 % ) : 1 perioperative cardiac arrest on atrioventricular block grade 3 , 1 case of febrile hypoxic atelectasis , and 1 colonic ischemia with transient renal failure with transient dialysis . Ten patients had a moderate systemic complication ( 10 % ) : 7 transitory elevations of creatinemia , 1 pneumonia , 1 prostatitis , 1 sigmoiditis , and 1 cardiac arrhythmia/atrial fibrillation ( CA/AF ) . Intensive care stay and hospitalization duration s were 24 hours ( range , 12 - 768 hours ) and 6 days ( range , 4 - 39 days ) , respectively . Four local complications occurred : 1 limb thrombosis , 1 compartment syndrome , 1 spleen rupture , and 1 parietal hematoma . On multivariate analysis , the overall procedure time was a predictive factor of severe systemic complications ( P=0.02 ) . Follow-up was 42 months ( range , 1 - 97 months ) . Two patients required late surgery ( 2 % ) : 1 for limb thrombosis after neuroendovascular procedure and 1 for iliac thrombosis . Morphologic tests did not show any defects at the aortic prosthesis level . The only abdominal complication was a rupture at the level of a laparotomy conversion . The 6 late deaths ( 6 % ) were not related to the AAA . CONCLUSIONS This study shows that AAA laparoscopic surgery is a safe , long-lasting , minimally invasive technique in patients with st and ard surgical risk when EVAR can be considered BACKGROUND Endoaneurysmorrhaphy with intraluminal graft placement , described by Creech , is the gold st and ard for abdominal aortic aneurysm ( AAA ) repair .  Endovascular aneurysm repair has gained popularity for its minimal invasiveness and satisfying short-term results , but there are still many concerns about the long-term success of the procedure . Since 1998 , laparoscopic surgery has been proposed for AAA treatment . The potential benefits of a minimally invasive procedure reproducing the endoaneurysmorrhaphy results over time have been advocated . In our experience , h and -assisted laparoscopic surgery ( HALS ) has been routinely used for the open-surgery transperitoneal/retroperitoneal approach and for endovascular aneurysm repair . After 4 years , we are able to define the early and middle-term results of such laparoscopic-assisted treatment . METHODS From October 2000 to March 2004 , 604 consecutive nonurgent AAAs were treated at our institution . Of these , 122 ( 20.2 % ) were treated by HALS .  Exclusion criteria for HALS were hostile abdomen ( previous major abdominal or aortic surgery ) , bilateral diffuse common iliac and /or hypogastric aneurysms , massive aortoiliac calcifications , and severe cardiac ( ejection fraction < 35 % ) and respiratory ( P(O2 ) < 60 mm Hg or carbon dioxide > 50 mm Hg ) insufficiency . Juxtarenal and proximal iliac aneurysms were not a contraindication , nor was obesity . In all patients , we performed a minilaparotomy ( 7 - 8 cm ) both for laparoscopic h and -assisted dissection and for endoaneurysmorrhaphy . All perioperative data were prospect ively recorded . Follow-up consisted of ultrasonography and clinical evaluation after 6 and 12 months and then every year after surgery . RESULTS The mean laparoscopic and total operative times were respectively 64 + /- 32 minutes and 257 + /- 70 minutes , the mean aortic cross-clamping time was 76 + /- 26 minutes , and the mean autotransfused blood volume was 1136 + /- 711 mL. The overall mortality and morbidity were respectively 0 % and 12.2 % . Morbidity was surgery related in only two cases ( bleeding from an ipogastric artery lesion and a leg graft thrombosis ) . The mean intensive care unit stay was 14.3 + /- 13 hours . Oral food intake was resumed after 27.4 + /- 15 hours , and patients were discharged after a mean of 4.4 + /- 1.7 days . Operative times were not affected by obesity , suprarenal aortic cross-clamping , or aneurysm size . Both concomitant iliac aneurysms and bifurcated graft implantation ( related to longer vascular reconstruction ) involved significantly longer operative times . The learning curve of the procedure ( comparing the first 30 patients with the last 92 patients ) led to significantly shorter endoscopic , cross-clamping , and total operative times ( P = .000 ) . The mean follow-up was 28.6 + /- 16 months . Three incisional hernias and one case of bowel occlusion were detected . All these cases ( 3.4 % ) required laparoscopic treatment . CONCLUSIONS The HALS technique is a safe and minimally invasive treatment for AAA ; it is useful for limiting the need for conventional open surgery and reducing the length of hospital stay . Despite the lack of r and omized studies , HALS seems to be associated with a better postoperative course than st and ard open surgery . HALS can also be considered as an equivalent of a well-established procedure and as a bridge between open and total laparoscopic surgery H and -assisted laparoscopic aneurysm resection enables the surgeon to use his tactile senses while performing a laparoscopic aneurysm repair . Even more complex procedures that involve suprarenal clamping of the aorta can be performed by using this laparoscopically assisted approach . Twenty-nine laparoscopic patients were compared with a control group of 19 patients who were operated on conventionally .  Transperitoneal h and -assisted laparoscopic aneurysm resection with a tube graft or a bifurcated graft was performed . The anastomosis was sutured with conventional instruments using the mini-incision as an access . The time for laparoscopy did not exceed 40 minutes . The incidence of complications did not vary between groups . The mean operating time was 135 minutes in the conventional group versus 180 minutes in the minimal invasive group . Intensive care stay and postoperative hospital stay were significantly shorter after the laparoscopic procedure . An oral diet was resumed significantly earlier , and the time until complete recovery was shortened in the miniaccess group . H and -assisted laparoscopic aneurysm resection can be performed safely with operating times almost as expeditiously as in open surgery . Because it can be offered to the majority of patients with aortic disease , the technique described has distinct advantages over a total laparoscopic approach and a less steep learning curve . Copyright © 2001 by W.B. Saunders Company CONTEXT Limited data are available to assess whether endovascular repair of abdominal aortic aneurysm ( AAA ) improves short-term outcomes compared with traditional open repair . OBJECTIVE To compare postoperative outcomes up to 2 years after endovascular or open repair of AAA in a planned interim report of a 9-year trial . DESIGN , SETTING , AND PATIENTS A r and omized , multicenter clinical trial of 881 veterans ( aged > or = 49 years ) from 42 Veterans Affairs Medical Centers with eligible AAA who were c and i date s for both elective endovascular repair and open repair of AAA . The trial is ongoing and this report describes the period between October 15 , 2002 , and October 15 , 2008 . INTERVENTION Elective endovascular ( n = 444 ) or open ( n = 43 
    Output:
    
Conclusions The outcomes from selected patients in selected centres demonstrate that elective laparoscopic repair of aortic aneurysms is feasible and comparable in safety to open repair ; it remains unclear , however , whether there are substantial advantages of this method compared with open and endovascular repair