***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background The role of laparoscopic resection ( LR ) in the management of extraperitoneal rectal cancer still is unclear . This study aim ed to compare perioperative and long-term results of laparoscopic and open resection ( OR ) for low and midrectal cancer . Methods A prospect i ve nonr and omized trial comparing patients su bmi tted to OR or LR for low and midrectal cancer at a single institution was conducted . Results The study included 191 consecutive patients : 98 patients who underwent LR and 93 who underwent OR .  The mean follow-up period was 46.3 months for LR and 49.7 months for OR . The conversion rate for LR was 18.4 % . With the use of LR , the mean time for complete patient mobilization was shorter ( 1.7 vs 3.3 days ; p < 0.001 ) and patients were earlier in passing flatus ( 2.6 vs 3.9 days ; p < 0.001 ) and stools ( 3.8 vs 4.7 days ; p < 0.01 ) , and in resuming oral intake ( 3.4 vs 4.8 days ; p < 0.001 ) . The mean hospital stay was shorter for LR , but the difference did not reach significance ( 11.4 vs 13 days ) . Morbidity and mortality rates were similar : LR ( 24.4 % and 1 % ) and OR ( 23.6 % and 2.2 % ) . Laparoscopic patients presented a higher rate of anastomotic fistulas ( 13.5 % vs 5.1 % ) and reoperations ( 6.1 % vs 3.2 % ) but the difference was statistically nonsignificant . Laparoscopic resection presented a significantly lower local recurrence rate ( 3.2 % vs 12.6 % ; p < 0.05 ) . The cumulative survival and disease-free rates at 5 years were , respectively , 80 % and 65.4 % after LR and 68.9 % and 58.9 % after OR ( nonsignificant difference ) . Stage-by-stage comparison showed prolonged cumulative survival for stages III and IV cancer in LR ( 82.5 % vs 40.5 % ; p = 0.006 and 15.8 % vs 0 % ; p = 0.013 , respectively ) and a reduced rate of cancer-related death for stage III in LR ( 11.4 % vs 51.9 % ; p = 0.001 ) . Conclusions As compared with conventional open surgery , LR for low and midrectal cancer is characterized by a faster recovery and similar overall morbidity ( but a higher rate of anastomotic leakages ) , and does not present any adverse oncologic effect Purpose Laparoscopic surgery of colon cancer has been accepted to be oncologically adequate compared with open resection . However , the situation in rectal cancer remains unclear , because anatomy and complex surgical procedures might specifically influence the long-term outcome . This study was design ed to analyze perioperative and long-term outcome of patients with rectal cancer after laparoscopic vs. open access surgery .  Methods A total of 389 patients ( 1998–2005 ) were prospect ively analyzed ; 114 patients had laparoscopic beginning , and 25 patients had conversion  and were separately analyzed . Eighty-nine patients remained in the laparoscopic group and 275 had open access surgery .  Results Both groups were comparable regarding age , gender , tumor localization , stage , and complications . Differences were found in harvested lymph nodes ( laparoscopic 13.5/open access 16.9 ; P = 0.001 ) and hospitalization ( 15.1/18.7 days ; P = 0.037 ) . Local recurrence rate and metachronous metastasis were comparable . In patients with deep anterior resection with total mesenteric excision , favorable long-term survival in the laparoscopic group was found ( P = 0.035 , log-rank ) . Conclusions Minimally invasive surgery is equivalent in the treatment of rectal cancer and shows advantages of shorter hospitalization and faster recovery . Especially in patients with low rectal cancer , minimally invasive surgery with exact preparation of the total mesenteric excision seems to be favorable compared with open access surgery 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 Abstract . Previous analyses of non- prospect ively r and omized trials have suggested that early oral postoperative feeding might be a benefit unique to laparoscopic surgery . However , some authors have indicated that early feeding can be tolerated by the majority of patients after elective open surgery . Aim : This prospect i ve r and omized study was undertaken to assess whether the time prior to oral intake of food after laparoscopy-assisted surgery is shorter than that after st and ard laparotomy . Methods : This trial included 40 patients who were divided r and omly into two groups before operation . Group I included 20 patients ( mean age , 52 years ; range , 15 – 77 years ) who underwent a laparoscopy-assisted colon or rectal procedure ( LAP ) . Group II consisted of 20 patients ( mean age , 56 years , range , 41 – 74 years ) who underwent surgery with a st and ard midline incision ( SMI ) .  On the evening after surgery , patients were allowed clear liquids ab libitum . This regimen was continued until the first postoperative day at which time they could elect to start eating a regular diet . If a patient had two episodes of vomiting , a nasogastric tube was inserted . Results : Five laparoscopic procedures were converted to SMI because of adhesions ( 25 % ) and an equal number of patients was excluded from the group that was treated in the traditional manner . Therefore , only 30 patients were included in the analysis . There were no deaths in this trial . Complications appeared in four of the patients in the LAP group and in two of the patients in the SMI group ( no significant difference ) . There were no statistically significant differences between the two groups in terms of the ability to tolerate the early oral intake of food , in the frequency of vomiting or in the incidence of insertion of a nasogastric tube . The time to the first bowel movement was 5.4 days in LAP and 5.5 days in SMI , and the difference was not significant . Conclusion : This study invali date s the cl aim by laparoscopic surgeons that earlier oral intake of food is tolerated by their patients than by patients who undergo st and ard procedures .Résumé . Des études r and omisées non prospect ives ont suggéré que la reprise précoce de l'alimentation orale peut être un bénéfice particulier à la chirurgie laparoscopique . Certains auteurs ont indiqué que la reprise précoce de l'alimentation orale peut être bien tolérée par la plupart des patients après chirurgie élective ouverte . Cette étude prospect i ve r and omisée a été entreprise pour déterminer si la reprise orale de l'alimentation après chirurgie laparoscopique peut être plus précoce qu'après une laparotomie st and ard .  Quarante patients ont été inclus dans cette étude et ont été divisés de manière r and omisée en deux groupes avant chirurgie . Le groupe 1 comporte 20 patients ( 15 à 77 ans , moyenne d'âge 52 ans ) qui ont subi une résection colique ou rectale laparoscopique ( LAP ) . Le groupe II comporte 20 patients ( 41 à 74 ans , moyenne d'âge 56 ans ) qui ont subi une chirurgie par une incision médiane st and ard ( SMI ) . Le soir de l'intervention chirurgicale , les patients ont été autorisés à boire librement . Ce régime a été continué le premier jour postopératoire à partir duquel les patients pouvaient débuter une alimentation normale . Si un patient présente deux épisodes de vomissements , une sonde naso-gastrique a été mise en place . Cinq interventions laparaoscopiques ont dûêtre converties en chirurgie ouverte en raison d'adhérences ( 25 % ) et un nombre égal de patients ont été exclus du groupe qui a été traité de manière traditionelle . En conséquence , 30 patients ont été inclus dans l'analyse . Aucun décès n'est à déplorer . Quatre complications sont survenues chez des patients du groupe laparoscopique et deux dans le collectif des patients ayant subi un chirurgie ouverte ( pas de différence statistique significative ) . Il n'y a pas de différence statistique significative entre les deux groupes en ce qui concerne la tolérance à la reprise orale de l'alimentation , à la fréquence des vomissements ou à la nécessité de réinsérer un tube naso-gastrique . La première exonération est survenue au 5.4 jour dans le groupe laparoscopique et au 5,5 jour dans le groupe de chirurgie ouverte sans que la différence ne soit significative . En conclusion : Cette étude infirme l'idée que la chirurgie laparoscopique permet une reprise précoce et bien tolérée de l'alimentation en comparaison à la chirrugie ouverte AIM To evaluate the feasibility of laparoscopic resection of rectal carcinoma and to compare the short-term outcome of laparoscopic procedure with conventional open surgery for rectal cancer . METHODS Thirty-eight patients with rectal cancer were included in a prospect i ve non-r and omized study . The patients were assigned to  laparoscopic ( n=18 ) or open ( n=18 ) colorectal resection . Case selection , surgical technique , and clinical and pathological results were review ed . RESULTS The operative time was longer in laparoscopic resection group ( LAP ) than in open resection group ( 189+/-18 min vs 146+/-22 min 
    Output:
    
Conclusions On the basis of evidence of both r and omized and prospect i ve controlled series , mortality and morbidity RR , including subgroup analysis , were significantly lower after laparoscopic compared to open surgery