***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: Objective : We report a multicentered r and omized controlled trial across Australia and New Zeal and comparing laparoscopic-assisted colon resection ( LCR ) with open colon resection ( OCR ) for colon cancer . Background : Colon cancer is a significant worldwide health issue . This trial investigated whether the short-term benefits associated with LCR for colon cancer could be achieved safely , without survival disadvantages , in our region . Methods : A total of 601 patients with potentially curable colon cancer were r and omized to receive LCR or OCR . Primary endpoints were 5-year overall survival , recurrence-free survival , and freedom from recurrence rates , compared using an intention-to-treat analysis . Results : On April 5 , 2010 , 587 eligible patients were followed for a median of 5.2 years ( range , 1 week–11.4 years ) with 5-year confirmed follow-up data for survival and recurrence on 567 ( 96.6 % ) . Significant differences between the 2 trial groups were as follows : LCR patients were older at r and omization , and their pathology specimens showed smaller distal resection margins ;  OCR patients had some worse pathology parameters , but there were no differences in disease stages . There were no significant differences between the LCR and OCR groups in 5-year follow-up of overall survival ( 77.7 % vs 76.0 % , P = 0.64 ) , recurrence-free survival ( 72.7 % vs 71.2 % , P = 0.70 ) , or freedom from recurrence ( 86.2 % vs 85.6 % , P = 0.85 ) . Conclusions : In spite of some differences in short-term surrogate oncological markers , LCR was not inferior to OCR in direct measures of survival and disease recurrence . These findings emphasize the importance of long-term data in formulating evidence -based practice guidelines 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 Purpose This study was design ed to evaluate the impact of  laparoscopic rectal resection  on short-term postoperative morbidity and costs . Methods A total of 168 patients with rectal cancer were r and omly assigned to laparoscopic ( n = 83 ) or open ( n = 85 ) resection . Outcome parameters were : postoperative morbidity , length of hospital stay , quality of life , long-term survival , and local recurrences . The mean follow-up period was 53.6 months . Cost-benefit analysis was based on hospital costs . Results Operative time was 53 minutes longer in the laparoscopic group ( P < 0.0001 ) . Postoperative morbidity rate was 28.9 percent in the laparoscopic vs. 40 percent in the open group ( P = 0.18 ) . The mean length of hospital stay was 10 ( 4.9 ) days in the laparoscopic group and 13.6 ( 10 ) days in the open group ( P = 0.004 ) . Local recurrence rate and five-year survival were similar in both groups ; however , the limited number of patients does not allow firm conclusions . Quality of life was better in the laparoscopic group only in the first year after surgery ( P < 0.0001 ) . The additional charge in the laparoscopic group was $ 1,748 per patient r and omized ( $ 1,194 the result of surgical instruments and $ 554 the result of longer operative time ) . The saving in the laparoscopic group was $ 1,396 per patient r and omized ( $ 647 the result of shorter length of hospital stay and $ 749 the result of the lower cost of postoperative complications ) . The net balance result ed in $ 351 extra cost per patient r and omly allocated to the laparoscopic group . Conclusions Short-term postoperative morbidity was similar in the two groups . Laparoscopic resection reduced length of hospital stay , improved first-year quality of life , and slightly increased hospital costs 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 A retrospective analysis of age‐related postoperative morbidity in the Australia and New Zeal and prospect i ve r and omized controlled trial comparing  laparoscopic and open resection for right‐ and left‐sided colonic cancer is presented Most patients with colorectal cancer are elderly , but there are few data on the optimal surgical treatment for this age group and most studies are observational . We have review ed the characteristics of r and omized trials reporting laparoscopic surgery for colorectal cancer to determine the degree to which the elderly are represented Background : Laparoscopy has revolutionized many abdominal surgical procedures . Laparoscopic colectomy has become increasingly popular . The short- and long-term benefits and satisfactory surgical oncological treatment of colorectal cancer by laparoscopic-assisted resection remain topical . The long-term outcomes of all international r and omized controlled trials are still awaited , and short-term outcomes are important in the interim . Methods : Between January 1998 and April 2005 , a multicenter , prospect i ve , r and omized clinical trial in patients with colon cancer was conducted . Six hundred and one eligible patients were recruited by 33 surgeons from 31 Australian and New Zeal and centers . Patients were allocated to colectomy by either laparoscopic-assisted surgery ( n = 294 ) or open surgery ( n = 298 ) . Patient demographics and secondary end-points , such as operative and postoperative complications , length of hospital stay , and histopathological data , will be presented in this article . Analysis was by intention-to-treat . Survival will be reported only as the study matures . Results : Histopathological parameters were similar between the two groups , except in regard to distal resection margins . There was no statistically significant difference found in postoperative complications , reoperation rate , or perioperative mortality . Statistically significant differences in quicker return of gastrointestinal function and shorter hospital stay were identified in favor of laparoscopic-assisted resection . A statistically significant increased rate of infective complications was seen in cases converted from laparoscopic-assisted to open procedures but with no difference in reoperation or in-hospital mortality . Conclusions : Laparoscopic-assisted colonic resection gives significant improvements in return of gastrointestinal function and length of stay , with an increased operative time and no difference in the postoperative complication rate BACKGROUND Although laparoscopic resection of colorectal carcinoma improves post-operative recovery , long-term survival and disease control are the determining factors for its application . We aim ed to test the null hypothesis that there was no difference in survival after laparoscopic and open resection for rectosigmoid cancer . METHODS From Sept 21 , 1993 , to Oct 21 , 2002 , 403 patients with rectosigmoid carcinoma were r and omised to receive either  laparoscopic assisted ( n=203 ) or conventional open ( n=200 ) resection of the tumour .  Survival and disease-free interval were the main endpoints . Patients were last followed-up in March , 2003 . Perioperative data were recorded and direct cost of operation estimated . Data were analysed by intention to treat . FINDINGS The demographic data of the two groups were similar . After curative resection , the probabilities of survival at 5 years of the laparoscopic and open resection groups were 76.1 % ( SE 3.7 % ) and 72.9 % ( 4.0 % ) respectively . The probabilities of being disease free at 5 years were 75.3 % ( 3.7 % ) and 78.3 % ( 3.7 % ) , respectively . The operative time of the laparoscopic group was significantly longer , whereas postoperative recovery was significantly better than for the open resection group , but these benefits were at the expense of higher direct cost . The distal margin , the number of lymph nodes found in the resected specimen , overall morbidity and operative mortality did not differ between groups . INTERPRETATION Laparoscopic resection of rectosigmoid carcinoma does not jeopardise survival and disease control of patients . The justification for adoption of laparoscopic technique would depend on the perceived value of its effectiveness in improving short-term post-operative outcomes PURPOSE The aim of this study was to evaluate whether  laparoscopic colorectal surgery  can modify the risk factors for the occurrence of postoperative morbidity . METHODS A total of 384 consecutive patients with colorectal disease were r and omized to laparoscopic resection ( n = 190 ) or open resection ( n = 194 ) . On admission , demographics , comorbidity , and nutritional status were recorded . Operative variables , patient outcome , and length of stay were also recorded . Postoperative complications were registered by four members of staff not involved in the study . RESULTS The overall morbidity rate was 27.1 percent , with the rate in the laparoscopic group ( 18.7 percent ) being less than that in the open group ( 31.5 percent ; P = 0.003 ) . Patients who underwent laparoscopic resection had a faster recovery of bowel function ( P = 0.0001 ) and a shorter length of stay ( P = 0.0001 ) . In the whole cohort of patients , multivariate analysis identified open surgery ( P = 0.003 ) , duration of surgery ( P = 0.01 ) 
    Output:
    
This systematic review suggests that age itself should not be a factor when considering the best surgical option for older patients