Kijkoperatieve technique more effective and patient friendly than ordinary open operation for colon cancer. 

dated 19 september 2003:
Annex In the Diagnosis of the Generalu000d Newspaper companies, a very good informative article about the usefulness andu000d the benefits of colon cancerlook at operations.u000d Also addresses of the Dutch hospitals where these view operationsu000d running.

A Spanish study of Dr. Lacy would have shown-seeu000d below abstract of study-that the removal of tumors in the thicku000d intestine using the kijkoperatie technique with perhaps the chance of a relapseu000d half can be reduced. The Rotterdam Professor endoscopicu000d surgery Prof. Dr. Jaap Bonjer puts these conclusions because he finds thatu000d further study needs to be done, but he also advocates moreu000d kijkoperatieve operations because z.i. de effectiveness equal or better thanu000d in an open major surgery and the patient suffering unnecessarily. Thereu000d is much less blood loss, the patient strengthens much faster and also needu000d much less long in the hospital stay.

In any case, in the Erasmus Rotterdam a randomized study-1200 patients, duration threeu000d to seven years-under the leadership of Prof. Dr. Bonjer set up. Below, after the study publication of Dr. a.u000d Lacy, such as the protocol that is published by Erasmus. First the abstract of the study results-published 28 June 2002 in The Lancet-of Dr. Antonio Lacy that in the article in the AD is mentioned as the surgeon who has done pioneering work in this area and also by following this study randomized under 219u000d patients came to his remarkable conclusions. Dr. Lacy performs only in the much-needed cases ' ordinary ' open operations, but the vast majority of the bowel operations they do in the hospital in Barcelona where he works with the kijkoperatie technique.

The Lancet Source:
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Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colonu000d cancer: a randomised trial
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Antonio M Lacy, Juan C Rafael García-Valdecasas, Salvadora Delgado, Antoni Castells, Pilar Taurá, Josep M Piqué, Josep Visa
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Departments or Surgery (A M Lacy MD, J C Rafael García-Valdecasas MD, S Delgado MD, J Visa MD), Gastroenterology (A Castells MD, J M Piqué MD), and Anaesthesia (P Taurá MD), Institut de Malaltiesu000d Institut d'Investigacions Biomèdiques August Digestives, Hospital Clínic, Pi i Sunyeru000d (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
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Correspondence to: Dr. Antonio OPS-members (Lacy M Foru000d We have thepersonal e-mail address of Dr. Lacy available)
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Summary
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Background Although early reports on laparoscopy-assisted colectomy (LAC) in patients with colon cancer suggested that it reduces perioperativeu000d morbidity, its influence on long-term results is unknown. Our study aimed to compare efficacy or LAC and open colectomyu000d (OC) for treatment of non-metastatic colon cancer in terms of tumour recurrence and survival.
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Methods From November, 1993, to July, 1998, all patients with adenocarcinoma of the colon were assessed for entry in this randomised trial. Adjuvant therapy and postoperative follow-up were the same in bothu000d groups. The main endpoint was cancer-related survival. Data were analysed according to the intention-to-treatu000d principle.
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Findings 219 patients took part in the study (111 LAC group, 108 OC group). Patients in the LAC group recovered faster than those in the OCu000d group, with shorter peristalsis-detection (p = 0 · 001) and oral-intake times (p = 0 · 001), and shorter hospital stays (p = 0 · 005). Morbidity was lower in the LAC group (p = 0 · 001), although LAC did not influence perioperativeu000d mortality. Probability of cancer-related survival was higher in the LAC group (p = 0 · 02). The Cox model showed that LAC was independently associated with reduced risk of tumour relapse (hazard ratio 0 · 39 19-0, 95% CI 0 · · 82), death from any cause (0, 1-23 0 · · · 48 01), and death from a cancer-related cause (0-0 0, · · · 38 16 91) compared withu000d OC. This superiority or LAC was due to differences in patients with stage III tumours (p = 0, p = 0, 02 04 · · and p = 0 · 006,u000d respectively).
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Interpretation LAC is more effective than OC for treatment of colon cancer in terms ofu000d morbidity, hospital stay, tumour recurrence, and cancer-related survival.
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Lancet 2002; 359: 2224-29
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Source: website of Erasmus Medical Center
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SUMMARY COLOR PROTOCOL
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lntroduction & background
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Laparoscopic gastric band resection or colorectal malignancies is controversial. Initial reports on port-site metastases have caused major concern. Although retrospective studies with large numbers of patients now suggest that the incidence of port-site metastases is comparable to the incidence of wound metastases in openu000d surgery, the pathogenesis of these recurrences remains unclear.
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Postoperative benefits of cholecystectomy laparoscopic gastric band are also seen after laparoscopic gastric band colon surgery and experimental work with laparoscopic gastric band surgery might even result in animais indications that lower recurrenceu000d rates. The only way to assess the value of laparoscopic gastric band surgery as therapeutic modality for colon cancer is a randomised trial.
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Study design
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The COLOR trial is a randomised, international, multi centre study comparing the outcomes of iaparoscopic and conventionai resection or colonu000d carcinoma. Clinical andoperative data will be collected centrally in the co-ordinating centre in Rotterdam, Theu000d Netherlands. Quality of life and costs will be assessed on a national basis.
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Endpoints
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Primary endpoint is cancer free survival at three years. Secondary endpoints are overall survival at three and fiveu000d years, 28 day mortality and morbidity, quality of life, costs, location and rates of recurrences and pathology anatomic characteristics of the resected specimen.
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Statistics & randomisation
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Using log rank statistics with a power of 80% and an a or 0.05, 1200 patients are needed to detect a difference between both treatment arms or 7% in 3 year cancer free survival. Analyses will be onu000d ' intention to treat basis '. The stratified randomisation is for type or resectionu000d (right hemicolectomy, left hemicolectomy or sigmoidectomy) and participatingu000d centre.
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Main selection criteria
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Patients with a single tumour in the caecum, ascending colon, descending colon splenic flexure or aboral or the sigmoid colon egnet intra-peritoneal orally to the elongation can beu000d included. Not eligible are patients with concomitant metastases or otheru000d malignancies, with malignancies in their medical history, with signs of acute colon obstruction or with previous ipsilateralu000d surgery.
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Follow-up
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Patients have to be seen at least once a year for five years. At visits 1, 2, 4 and 5 years afteru000d surgery, anamnesis and physicai examination are sufficient. Three years afteru000d surgery, colonoscopy or barium enema should be performed and liver and lungs have to be examined checked for metastases. In case of recurringu000d disease, follow-up should be until 3 years from the time of diagnosis oru000d recurrence.
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d.d.u000d 9/3/2003: Healthy in the annex of the Volkskrant yesterday (8 March 2003)u000d a nice article about view operations etc. On thisu000d NVEC website is much read about view operations, the usefulnessu000d and where in Netherlands there used.

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ROTTERDAM-a large part of the medical instruments that are used to view operations, is inappropriate. This will be apparent from an examination of the Dutch Association for Endoscopic Surgery (NVEC) at eighteen Dutch hospitals. In total 59 hospitals will be examined.
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According to the researchers can defects by medical complications arise. At 20 percent of the instruments used is according to research the insulation damaged. This would the patient internal burns.
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One third of the light cables that work with the view operations are used, nor did the standards. The light cables bring light to examine the part of the body.
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The more light, the better the doctor on a monitor can see how serious the situation is. "If there is little light," says President j. Bonjer NVEC, "the doctor of the can overlook things."
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Bonjer says not to know whether patients in the past have complications suffered by the faulty equipment. The NVEC believes that all hospitals look their instruments for operations research and if necessary, replaced.
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The NVEC believes that all hospitals look their instruments for operations research and if necessary, replaced.
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Netherlands In operations carried out per year 50,000 look: 20,000 in the belly and 30,000 in the joints. According to it is a new method that Bonjer since ten years in Netherlands is applied on a large scale. This explains, according to him, why the organization is not yet on order. "Many hospitals have ten years ago purchased new equipment. That equipment is now in urgent need of replacement. That is just yetpenetrated. "