***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 
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    ***EXAMPLES*** 
    Input: Purpose Elective laparoscopic sigmoid resection ( LSR ) for symptomatic diverticular disease is supposed to have significant short-term advantages compared to open surgery ( open sigmoid resection ( OSR ) ) . This opinion is rather based on inferences from trials on colonic resections for malignant diseases or minor laparoscopic surgery . This r and omized controlled trial was conducted to compare quality of life as well as morbidity and clinical outcome after LSR vs. OSR following a midterm follow-up period . Methods Patients presenting with a symptomatic sigmoid diverticular disease stage II/III ( Stock/Hansen ) were r and omly allocated to LSR or OSR in a prospect i ve multicenter trial . Endpoints included the quality of life assessed with a st and ardized question naire , postoperative mortality , and complications within the follow-up of 12 months after operation . Results A total of 143 patients r and omized between 2005 and 2008 in 12 centers could be analyzed . The recruitment was aborted for nonachievement of the planned sample size . Seventy-five patients were allocated to LSR  , and 68 received  OSR . Nine operations were converted to OSR ( 9 % ) and analyzed as intention to treat . Groups were comparable for age , gender , body mass index , comorbidity , and indication for surgery . Operation time was longer for LSR ( p < 0.001 ) . Quality of life did not differ between LSR and OSR , either during the early postoperative course or after 12 months ( p = 0.172 ) . Also , mortality and morbidity , including subgroups of major and minor morbidity , were compared . Conclusion LSR was not superior to OSR regarding postoperative quality of life and incidence of complications in this trial BACKGROUND This analysis examines gastrointestinal recovery in patients who underwent bowel resection ( BR ) in 3 recent trials . METHODS Patients who underwent BR in the placebo groups of 3 r and omized , double-blind , phase III , parallel-group , multicenter alvimopan efficacy trials were analyzed . RESULTS Most patients tolerated solid food and had a bowel movement by postoperative day 4 . The majority of patients were discharged from the hospital by day 6 , but 24.4 % required a prolonged hospital stay or readmission . The incidence of nausea was highest on the day of surgery and decreased thereafter , whereas vomiting was uncommon on the day of surgery but increased slightly on postoperative days 1 to 6 . The incidence of postoperative nasogastric tube insertion was highest ( 12 % ) on day 2 . CONCLUSIONS This analysis provides valuable clinical insight into gastrointestinal recovery after BR in a large homogenous patient population receiving multimodal care Background : A shorter duration of postoperative ileus and earlier oral alimentation of patients may be a clinical ly relevant benefit of laparoscopic compared with conventional colorectal resection . Patients / Methods : A total of 60 patients were r and omised to either laparoscopic ( n=30 ) or conventional ( n=30 ) resection of colorectal tumours . Major endpoints were the postoperative time to the first bowel movement and the time until oral feeding without parenteral alimentation was tolerated . Minor endpoints were the postoperative interval to the first peristalsis and first passage of flatus , the distribution of radio-opaque markers in abdominal radiographs on day 3 and day 5 and the incidence of postoperative vomiting . Results : Age , gender , ASA-classification and type of resection were comparable in thetwo groups . Peristalsis was first noticed 26±9 h after laparoscopic and 38±17 h after conventional colorectal resection ( P<0.01 ) . First flatus occurred 50±19 h after laparoscopic and 79±21 h after conventional surgery ( P<0.01 ) . The incidence of postoperative vomiting was similar in both groups . Three days after surgery radio-opaque markers were found more often in the right colon ( P<0.01 ) and less often in the small intestine ( P<0.05 ) in laparoscopic compared with conventional patients . Five days after laparoscopic surgery , more markers had reached the left colon ( P<0.05 ) . The first bowel movement occurred 70±32 h after laparoscopic and 91±22 h after conventional resection ( P<0.01 ) . Oral feeding without additional parenteral alimentation was tolerated 3.3±0.7 days after laparoscopic and 5.0±1.5 days after conventional surgery ( P<0.01 ) . Conclusion : The shorter duration of postoperative ileus allows earlier restoration of oral feeding after laparoscopic compared with conventional colorectal resection and therefore increases quality of life immediately after resection of colorectal tumours Purpose Postoperative ileus ( POI ) prolongs hospital stay and increases risk of postoperative complications . We conducted a r and omized , sham-controlled trial to evaluate whether acupuncture reduces POI more effectively than sham acupuncture . Methods Colon cancer patients undergoing elective colectomy were r and omized to receive 30 min of true or sham acupuncture twice daily during their first 3 postoperative days . GI-3 ( the later of the following two events : time that the patient first tolerated solid food , AND time that the patient first passed flatus OR a bowel movement ) and GI-2 ( the later of the following two events : time patient first tolerated solid food AND time patient first passed a bowel movement ) were determined . Pain , nausea , vomiting , and use of pain medications were evaluated daily for the first 3 postoperative days . Results Ninety patients were r and omized . Eighty-one received the allocated intervention : 39 in the true acupuncture group and 42 in the sham acupuncture group , all evaluated for the primary endpoint . The mean time to GI-3 was 149 h [ st and ard deviation ( SD ) 71 h ] and 146 ( SD 62 h ) after surgery for the acupuncture group and the sham acupuncture group ( difference between means −2 h ; 95 % confidence interval −31 , 26 ; p = 0.9 ) . No significant differences were found between groups for secondary endpoints . Conclusions True acupuncture as provided in this study did not reduce POI more significantly than sham acupuncture . The study was limited by a st and ard deviation much larger than expected , suggesting that a study with a larger sample size might be required INTRODUCTION Enhanced Recovery After Surgery ( ERAS ) programs have demonstrated significant reduction in hospital stay for patients undergoing colonic surgery ;  however , their impact on long-term outcomes , such as postoperative fatigue ( POF ) , has not been fully established . AIM To assess the impact of an ERAS program on POF and recovery following elective open colonic surgery . METHOD In a prospect i ve study , 26 consecutive patients undergoing open colonic surgery under a conventional care plan were compared with 26 consecutive patients in an ERAS program .  RESULTS Demographic and clinical characteristics were comparable at baseline . The median duration of total hospital stay ( 4 versus 7 d , P < 0.001 ) , rates of urinary tract infections ( P = 0.028 ) and ileus ( P = 0.042 ) were significantly smaller in the ERAS group . Postoperatively , POF significantly increased in both groups . However , peak POF score was significantly lower in the ERAS group ( P = 0.001 ) . In the first 30 d after surgery , Fatigue Consequence scores were also significantly smaller in the ERAS group . Overall , the total fatigue experience ( P = 0.035 ) and the total fatigue impact ( P = 0.005 ) were significantly smaller in the ERAS group . CONCLUSION The impact of ERAS programs may extend beyond the commonly reported short-term outcomes , and ERAS may accelerate overall recovery and return to normal function Objective : This study aim ed to compare the outcomes of laparoscopic resection ( LR ) with open resection ( OR ) for right-sided colon cancer . Methods : During the study period from June 2000 to December 2004 , 182 patients ( 84 men ) underwent elective resection for cancer of the right colon . Laparoscopic resection was performed in 77 patients , while 105 patients had open operations . Patients who underwent operations on an emergency basis were excluded . Data on the patients ' demographics , operative details , and postoperative complications were collected prospect ively . The outcomes of patients with laparoscopic resection  were compared with those of patients with  open surgery . Results : There was no difference in the age , sex , presence of premorbid medical conditions , and blood loss between the 2 groups . The mean operative time for open resection was 115.4 minutes and that for laparoscopic resection was 165.1 minutes ( P<0.001 ) . Among the 77 patients who underwent laparoscopic resection , 7 ( 9 % ) required conversion to an open operation . There was no difference in postoperative surgically related complications including wound infection , leakage , intestinal obstruction , postoperative ileus . Nonsurgical-related complications were also similar . The median time to resumption of a normal diet was 3 days and 4 days in the laparoscopic and open groups , respectively . The median hospital stay in patients with laparoscopic resection was significantly shorter than in patients with open surgery ( 6.0 days vs 7.0 days , P<0.001 ) . The 2-year overall survival rates were 74 % in both groups ( P=0.904 ) . In the converted to open ( LCOR ) group , the hospital stay was significantly longer ( LR vs OR vs LCOR , 5.5 days vs 7.0 days vs 9.0 days respectively , P<0.001 ) . Conclusion : Laparoscopic right hemicolectomy is a safe option for cancers of the right colon . It is associated with a shorter hospital stay and earlier resumption of a normal diet . Mortality and morbidity are similar to that with the open approach . There is no compromise in the survival of patients 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 
    Output:
    
The used definition of PPOI , the type of surgery and access ( laparoscopic , open ) and the duration of surgery lead to significant variability of reported PPOI incidence between studies .
The incidence of PPOI is lower after laparoscopic colonic resection .
There is a large variation in the reported incidence of PPOI .