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Table 2 Comparison of pathologic outcomes and perioperative clinical outcomes between the open and laparoscopic surgery groups

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 %)  
  1. WD Well differentiated, MD Moderately differentiated, PD Poorly differentiated, MUC Mucinous adenocarcinoma, signet Signet ring cell type, N/A Not assessed, HALS Hand-assisted laparoscopic surgery, LAP Conventional laparoscopic surgery, SILS Single-incisional laparoscopic surgery
  2. a N/A 9 (4.2 %) cases
  3. b 25 (11.3 %) cases
  4. c 30 (13.5 %) cases