Clinical comparison of laparoscopy vs open surgery in a radical operation for rectal cancer: A retrospective case-control study

Table 1 Clinical comparison of radical operation data for rectal cancer

	LRR (n = 492)	ORR (n = 424)	P value
Gender
Male	301	243	0.235
Female	191	181
Age (yr, mean ± SD)	64.5 ± 11.9	63.3 ± 12.3	0.290
BMI (kg/m2)	23.274 ± 3.463	23.438 ± 3.533	0.999
Preoperative comorbid diseases	52.8% (260/492)	58.7% (249/424)	0.074
Hypertension	60	57
Coronary heart disease	37	34
Arrhythmia	21	20
COPD	10	13
Pulmonary infection	3	5
Asthma	2	3
Diabetes	42	70
Hepatic cirrhosis	4	3
Cerebral infarction	20	6
Renal failure	17	7
Autoimmune	5	0
Others	39	31
ASA score			0.498
I	109	108
II	321	264
III	62	52
Previous abdominal surgery	75 (15.2%)	65 (15.3%)	0.971

LRR: Laparoscopy in radical resection; ORR: Open radical resection; BMI: Body mass index; COPD: Chronic obstructive pulmonary disease; ASA: American Society of Anesthesiologists.

Table 2 Surgery index

	LRR (n = 492)	ORR (n = 424)	P value
Surgery duration (min)	143.89 ± 50.865	164.86 ± 67.993	< 0.001
Surgery bleeding (mL)	111.54 ± 97.148	154.03 ± 154.545	< 0.001
Maximum incision (cm)	4.14 ± 0.738	13.8 ± 2.603	< 0.001
Conversions to open	12 (2.4%)
Tumor diameter (cm)	4.338 ± 1.6387	4.325 ± 1.8274	0.914
Sample length(cm)	18.050 ± 5.1748	17.553 ± 5.7995	0.182
Proximal margin (cm)	10.487 ± 4.2906	10.673 ± 5.2175	0.567
Distal margin (cm)	3.214 ± 1.8727	2.873 ± 2.4913	0.022
Lymph nodes retrieved (unit)	11.09 ± 6.503	10.68 ± 6.321	0.338

LRR: Laparoscopy in radical resection; ORR: Open radical resection.

Table 3 Pathology findings

	LRR	ORR	χ2	P value
Differentiation			2.495	0.476
Well-differentiated	88	92
Moderate-differentiation	285	237
Poorly-differentiated	86	72
Mucinous cancer	33	23
pT			7.468	0.058
T1	33	29
T2	164	108
T3	207	193
T4	88	94
pN			6.865	0.076
N0	252	233
N1	147	96
N2	75	73
Nx	18	22
Lymph node metastasis				0.259
Yes	240	191
No	252	233
TNM stage				0.134
I	93	83
II	218	211
III	181	130

pT: Pathology Tumor; pN: Pathology Node; pM: Pathology metastasis; TNM: Tumor node metastasis.

Table 4 Perioperative complications for the 2 groups n (%)

	LRR (n = 492)	ORR (n = 424)	χ2	P value
Occurrence rate of perioperative complications	19.3% (95/492)	24.1% (102/424)	3.041	0.081
Intraoperative complications	10 (2)	4 (0.9)	1.795	0.180
Massive hemorrhage (> 1000 mL)	2 (0.41)	1 (0.24)
Organ injury	3 (0.61)	2 (0.47)
Equipment disorders	4 (0.81)	0
Other	3 (0.61)	1 (0.24)
Post-operative complications	85 (17.3)	98 (23.31)	4.853	0.028
Anastomotic leakage	24 (4.88)	15 (3.54)
Wound infection	7 (1.42)	27 (6.37)
Ileus	8 (1.63)	9 (2.12)
Anastomotic hemorrhage	3 (0.61)	2 (0.47)
Pelvic abscess	1 (0.20)	1 (0.24)
Abdominal hemorrhage	7 (1.42)	4 (0.94)
Peritonitis/septic shock	9 (1.83)	7 (1.65)
Incisional/port herniation	4 (0.81)	10 (2.36)
Deep vein thrombosis	1 (0.20)	0
Lymphatic fistula	1 (0.20)	0
Pulmonary infection	8 (1.63)	2 (0.47)
Acute cardiac failure	2 (0.41)	10 (2.36)
Urinary infection	4 (0.81)	4 (0.94)
Incision split	4 (0.81)	5 (1.18)
Sudden death	2 (0.41)	2 (0.47)

LRR: Laparoscopy in radical resection; ORR: Open radical resection.

Table 5 Postoperative recovery

	LRR (n = 407)	ORR (n = 326)	P value
Peristalsis recovery (d)	1.91 ± 0.89	2.41 ± 1.13	< 0.001
Exsufflation recovery (d)	3.03 ± 1.25	3.96 ± 1.53	< 0.001
Off-bed (d)	2.80 ± 1.26	3.38 ± 1.07	< 0.017
Liquid intake (d)	3.90 ± 1.446	5.08 ± 1.763	< 0.001
Semi-liquid intake (d)	6.55 ± 1.910	7.59 ± 2.065	< 0.001
Abdominal drainage (d)	9.48 ± 7.386	11.07 ± 10.484	< 0.008
Retention catheterization (d)	5.63 ± 3.613	6.67 ± 4.043	< 0.001
Post-op hospital stay (d)	12.27 ± 3.156	18.32 ± 5.406	< 0.001
Total hospital stay (d)	21.50 ± 4.991	25.81 ± 7.868	< 0.001

LRR: Laparoscopy in radical resection; ORR: Open radical resection.

Table 6 Postoperative analgesics and pain scores

	LRR (n = 492)	ORR (n = 424)	χ2	P value
Analgesic usage			95.31	< 0.001
No	299	121
PCIA	152	273
Short-acting drug	41	30
Post-op pain degree			21.43	< 0.001
Mild	263	193
Medium	213	186
Severe	16	45

LRR: Laparoscopy in radical resection; ORR: Open radical resection; PCIA: Patient controlled intravenous analgesia.

Table 7 Economic costs of the operations

	LRR (n = 492)	ORR (n = 424)	P value
Operation fee (RMB)	13628 ± 6771	10761 ± 5056	< 0.001
Medication (RMB)	15859 ± 10203	17562 ± 7006	0.06
Total hospitalization (RMB)	40889 ± 19356	42381 ± 17915	0.234

LRR: Laparoscopy in radical resection; ORR: Open radical resection.

Table 8 Postoperative survival rates

	LRR	ORR	P value
Post-op 1-yr
I	99.2%	93.8%	0.402
II	94.7%	92.8%	0.489
III	91.9%	87.8%	0.178
Total survival rate	93.6%	94.0%	0.534
Post-op 3-yr
I	90.3%	91.6%	0.774
II	86.2%	79.1%	0.052
III	70.7%	69.2%	0.777
Total survival rate	80.9%	78.1%	0.284
Post-op 5-yr
I	88.2%	89.2%	0.837
II	81.7%	76.8%	0.140
III	66.9%	65.4%	0.787
Total survival rate	77.0%	75.2%	0.416

LRR: Laparoscopy in radical resection; ORR: Open radical resection.