LACES 2: A multicentre, randomised controlled trial of Laparoscopic versus Open Colorectal Surgery in the Acute Setting

Project Description

Approximately 30,000 patients undergo an emergency laparotomy within the NHS yearly. An emergency laparotomy is an open operation which is undertaken for a variety of diseases, a third of those are for diseases affecting the large bowel, including colorectal cancer, diverticular disease and inflammatory bowel disease. There is emerging evidence in the emergency setting that a keyhole (laparoscopic) operation can be undertaken. However, the evidence is limited to reports based on small numbers of patients who have been highly selected; this prevents the evidence from being applicable to all patients requiring an emergency colorectal operation. In the planned (elective) setting, keyhole surgery is routinely used for operations involving the large bowel, with good results, including less pain, better recovery and improved quality of life, however in the emergency setting an open operation is carried out more frequently. Surgeons speculate that a keyhole operation for these patients is beneficial, however we are not sure, this is why more research is needed to give us better quality data before this technique is recommended in the emergency setting.

Aim and Objectives
The aim of LACES2 is to determine whether keyhole surgery for large bowel diseases in the emergency setting has better outcomes for patients than open surgery, assessed primarily by examining complications. The trial will also look at patients’ quality of life, severity of complications, length of hospital stay, survival rates, rates of re-operation and re-admission, and health economic outcomes.