A trial looking at conventional versus keyhole surgery and ways to improve recovery, for people with bowel cancer (EnROL)

Cancer type:

Bowel (colorectal) cancer

Colon cancer

Rectal cancer

Status:

Results

Phase:

Phase 3

This trial compared conventional surgery with keyhole surgery for bowel cancer, when both types of surgery were carried out alongside ways to improve recovery. This trial was supported by Cancer Research UK.

When this trial was done, surgery for bowel cancer was usually ‘open surgery’. This involves making a cut in the tummy (abdomen). Keyhole surgery is done through much smaller cuts in the abdomen. The surgeon uses a camera (laparoscope) to see inside the body to remove the cancer. Although the keyhole operation takes longer than open surgery, patients don’t spend as long recovering and there are fewer side effects. Research has shown that keyhole surgery is as good as conventional surgery for curing bowel cancer.

Surgeons sometimes use an ‘enhanced recovery programme (ERP)’ alongside surgery. ERP looks at your care before, during and after your operation to help you recover better and get you back to normal activities sooner. The programme includes pain control, getting people up and about sooner and getting them to eat and drink sooner after surgery.

The researchers in this trial are looking at an ERP alongside open surgery to see if it works as well as keyhole surgery at helping people to recover quicker from surgery.

The main aims of the study were to find out

How people rated their levels of tiredness after surgery
The number of days people stayed in hospital after surgery and how their recovery went

Summary of results

The trial team found that the people who had keyhole surgery spent fewer days in hospital. But there was no difference between the groups in levels of tiredness a month after surgery.

204 people took part in the trial and

Half had open surgery alongside the enhanced recovery programme (EPR)
Half had keyhole surgery alongside the EPR

The trial team looked at quality of life and how tired people said they felt before surgery and a month afterwards. When the trial team looked at the results, they found there was no difference between the 2 groups.

The trial team also looked at how long people stayed in hospital for after surgery. They found that on average it was

5 days for those who had keyhole surgery
7 days for those who had open surgery

The trial team also looked at the number of problems people had during or after surgery, such as infection or having to come back into hospital. They found no difference between the 2 groups.

The trial team concluded that even when open surgery was done with an EPR, recovery time was shorter with keyhole surgery.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.