From: Clinically suspected T4 colorectal cancer may be resected using a laparoscopic approach
Open surgery | Laparoscopic surgery | P-value | ||
---|---|---|---|---|
n = 222 | n = 71 | |||
Perioperative features | ||||
Type of surgery | 0.296 | |||
Right hemicolectomy | 69 (31.1 %) | 21 (29.6 %) | ||
Transverse colectomy | 4 (1.8 %) | 0 (0.0 %) | ||
Left hemicolectomy | 19 (8.6 %) | 6 (8.5 %) | ||
Anterior resection | 60 (27.0 %) | 24 (33.8 %) | ||
Low anterior resection | 52 (23.4 %) | 20 (28.2 %) | ||
Hartmann’s operation | 9 (4.1 %) | 0 (0.0 %) | ||
Abdominoperineal resection | 8 (3.6 %) | 0 (0.0 %) | ||
Total colectomy | 1 (0.5 %) | 0 (0.0 %) | ||
Operation time (minutes), median (range) | 155.5 (48–708) | 155.0 (79–399) | 0.249 | |
Blood loss (ml), median (range) | 175.0 (20–4200) | 100.0 (20–450) | <0.001 | |
Days to first flatus (days), median (range) | 4.0 (1–67) | 3.0 (1–11) | 0.001 | |
Days to first solid food (days), median (range) | 5.0 (2–69) | 4.0 (3–21) | 0.008 | |
Length of hospital stay (days), median (range) | 12.0 (2–116) | 9 (7–27) | <0.001 | |
Diverting stoma | 8 (3.60 %) | 2 (2.8 %) | 0.751 | |
Pathologic outcomes | ||||
Pathologic T stage no. ( %) | T2 | 9 (4.0 %) | 3 (4.2 %) | 0.041 |
T3 | 120 (54.1 %) | 50 (70.4 %) | ||
T4 | 93 (41.9 %) | 18 (25.4 %) | ||
Pathologic N stage no. ( %) | 0 | 118 (53.2 %) | 28 (39.4 %) | 0.085 |
1 | 57 (25.7 %) | 27 (38.0 %) | ||
2 | 47 (21.2 %) | 16 (22.5 %) | ||
Tumor size (cm), median (range) | 7.0 (1–20) | 5.5 (2–12) | <0.001 | |
Grade of differentiation no. ( %) | 0.136 | |||
WD + MD | 180 (81.1 %) | 63 (88.7 %) | ||
PD + MUC + Signet | 42 (18.9 %) | 8 (11.3 %) | ||
Lymphatic invasion | Negative | 143 (64.3 %)a | 44 (62.0 %) | 0.427 |
Positive | 70 (31.5 %) | 27 (38.0 %) | ||
Vascular invasion | Negative | 173 (77.9 %)b | 62 (87.3 %) | 0.914 |
Positive | 24 (10.8 %) | 9 (12.7 %) | ||
Perineural invasion | Negative | 176 (79.3 %)c | 56 (78.9 %) | 0.196 |
Positive | 30 (13.5 %) | 15 (21.1 %) | ||
Harvested lymph nodes, median (range) | 25.0 (4–138) | 20.0 (7–52) | <0.001 | |
Proximal resection margin, median (range) | 11.0 (2–57) | 7.0 (3–28) | <0.001 | |
Distal resection margin, median (range) | 5.5 (0–55) | 4.5 (1–28) | 0.241 | |
Adjuvant chemotherapy | 171 (77.0 %) | 60 (84.5 %) | 0.179 | |
Recurrence | 35 (15.8 %) | 10 (14.1 %) | 0.732 | |
Local recurrence | 11 (5.0 %) | 2 (2.8 %) | 0.741 | |
Distant recurrence | 24 (10.8 %) | 8 (11.3 %) | 0.914 | |
Postoperative complications | ||||
Overall | 70 (31.5 %) | 10 (14.1 %) | 0.004 | |
Wound seroma | 12 (17.1 %) | 3 (30 %) | ||
Wound dehiscence | 7 (10.0 %) | 0 (0 %) | ||
Paralytic ileus | 22 (31.4 %) | 2 (20 %) | ||
Mechanical obstruction | 2 (2.9 %) | 0 (0 %) | ||
Urinary retention | 7 (10.0 %) | 2 (20 %) | ||
Intraabdominal abscess | 2 (2.9 %) | 0 (0 %) | ||
Intraabdominal bleeding | 1 (1.4 %) | 1 (10 %) | ||
Gastrointestinal bleeding | 1 (1.4 %) | 0 (0 %) | ||
Chylous ascites | 2 (2.9 %) | 0 (0 %) | ||
Urinary injury | 0 (0.0 %) | 1 (10 %) | ||
Pneumothorax | 1 (1.4 %) | 0 (0 %) | ||
Acute myocardial infarction | 1 (1.4 %) | 0 (0 %) | ||
Pneumonia | 2 (2.9 %) | 0 (0 %) | ||
Delirium | 1 (1.4 %) | 0 (0 %) | ||
Anastomotic leakage | 9 (12.9 %) | 1 (10 %) | 0.285 | |
HALS/LAP/SILS | 42 (59.1 %) | |||
22 (31.0 %) | ||||
7 (9.9 %) | ||||
Open Conversion | 4 (5.6 %) |