Simultaneous laparoscopic multi-organ resection combined with colorectal cancer: Comparison with non-combined surgery

Table 1 Clinical characteristics of patients

	Right hemicolectomy			Low/anterior resection
	NC group	C group	P value	NC group	C group	P value
	(n = 263)	(n = 26)		(n = 827)	(n = 67)
Age at surgery (yr)1	62.7 (28-87)	65.1 (39-87)	0.314	62.4 (21-92)	62.3 (38-85)	0.980
Gender (%)			0.893			0.053
Male	125 (47.5)	12 (46.2)		495 (59.9)	32 (47.8)
Female	138 (52.5)	14 (53.8)		332 (40.1)	35 (52.2)
BMI (kg/m2)1	23.9 (14-22.9)	23.1 (18.6-30.3)	0.731	23.5 (14.4-40.5)	24.1 (16.8-31.9)	0.105
ASA score (%)			0.510			0.666
I	153 (58.2)	15 (57.7)		469 (56.7)	40 (59.7)
II	97 (36.9)	10 (38.5)		313 (37.8)	25 (37.3)
III	13 (4.9)	1 (3.8)		45 (5.4)	2 (3)
History of abdominal surgery (%)	53 (20.2)	5 (19.2)	0.911	187 (22.6)	16 (23.9)	0.812
Type of resection						0.602
Right hemicolectomy	268 (100)	26 (100)
Anterior resection				350 (42.3)	29 (43.3)
Low anterior resection				397 (48)	34 (50.7)
Colo-anal anastomosis				80 (9.7)	4 (6)

¹Values are expressed as the mean (range). NC: Non-combined; C: Combined; BMI: Body mass index; ASA: American Society of Anesthesiologists.

Table 2 Intraoperative and postoperative outcomes

	Right hemicolectomy			Low/anterior resection
	NC group	C group	P value	NC group	C group	P value
	(n = 263)	(n = 26)		(n = 827)	(n = 67)
Operation time (min)1	166.9 (65-397)	189.6 (120-320)	0.048	178 (60-430)	228.1 (80-480)	< 0.001
Intraoperative complication (%)	6 (2.3)	1 (3.8)	0.621	43 (5.2)	5 (7.5)	0.429
Conversion to open surgery (%)	2 (0.8)	1 (3.8)	0.139	4 (0.5)	1 (1.5)	0.287
Diverting stoma formation (%)	0	0		18 (2.2)	0	0.282
Postoperative hospital stay (d)1	7.8 (4-41)	8.6 (5-22)	0.363	7.9 (4-34)	8.8 (5-31)	0.104
Postoperative complication (%)
Overall	38 (14.4)	5 (19.2)	0.513	109 (13.2)	9 (13.4)	0.953
Major	9 (3.4)	1 (3.8)	0.910	30 (3.6)	4 (6)	0.335
Colon pathology1
Tumor size (cm)	5.3 (1-15)	5.5 (2-12)	0.803	4.0 (0.5-17)	4.2 (0.5-8)	0.468
Proximal margin (cm)	18.8 (2-72)	16.8 (5-45)	0.394	14.1 (1-54.5)	14 (5.5-30)	0.943
Distal margin (cm)	16.9 (1-60)	18 (3-37)	0.598	4.4 (1-30)	4.4 (1-14)	0.945
Retrieved LN	32.5 (2-93)	27.4 (7-62)	0.157	16.5 (1-80)	17.9 (5-65)	0.264
AJCC stage (%)			0.352			0.803
I	63 (24)	3 (11.5)		277 (33.5)	20 (29.9)
II	119 (45.2)	14 (53.8)		282 (34.1)	25 (37.3)
III	81 (30.8)	9 (34.6)		268 (32.4)	22 (32.8)

¹Values are expressed as the mean (range). NC: Non-combined; C: Combined; LN: Lymph node; AJCC: American Joint Committee on Cancer stage (6th edition).

Table 3 Perioperative complications

	Non-combined group	Combined group	P value
	(n = 1090)	(n = 93)
Postoperative complication (%)	147 (13.5)	14 (15.1)	0.667
Bleeding	7	0
Anastomosis leakage	27	3
Intra-abdominal abscess	9	1
Ascites	8	1
Wound problem	15	4
Delayed bowel movement	29	2
Bile leakage	0	1
Urinary retention	10	0
Respiratory problem	25	1
Phlebitis in injection site	13	0
Cerebral infarction	1	1
Deep vein thrombosis	1	0
Acute renal failure	1	0
Urinary tract infection	1	0

Table 4 Pathological findings of synchronous lesion

Synchronous lesion pathology (n = 98)
Stomach (n = 9)		Gall bladder (n = 56)
EGC	5	Primary malignancy	1
GIST	3	Stone	55
Schwannoma	1	Gynecologic resection (n = 21)
Kidney (n = 3)		Uterine leiomyoma	2
RCC	2	Serous cystadenoma	4
Leiomyoma	1	Endometriosis	7
Adrenal gland (n = 9)		Cyst	6
Adrenal metastasis	1	Teratoma	1
Adenoma	8	Abscess	1

EGC: Early gastric cancer; GIST: Gastrointestinal stromal tumor; RCC: Renal cell carcinoma.