Clinical efficacy and safety of laparoscopic hybrid surgery for simultaneous resection of colorectal cancer liver metastases

Table 1 Patient baseline data, n (%)/median (interquartile range)

Variable	TOS (n = 122)	LHS (n = 144)	P value
Gender			0.395
Male	70 (57.4)	90 (62.5)
Female	52 (42.6)	54 (37.5)
Age, years	60.00 (53.00, 67.00)	60.00 (51.25, 66.75)	0.813
Body mass index, kg/m2	23.44 (21.07, 25.36)	23.21 (21.49, 24.98)	0.943
Underlying conditions			0.570
Yes	72 (59.0)	80 (55.6)
No	50 (41.0)	64 (44.4)
Carcinoembryonic antigen at diagnosis, ng/mL			0.496
< 5	45 (36.9)	59 (41.0)
> 5	77 (47.5)	85 (59.0)
Cancer antigen 19-9 at diagnosis, U/mL			0.062
< 37	97 (79.5)	100 (69.4)
> 37	25 (20.5)	44 (30.6)
Preoperative chemotherapy			0.423
Yes	82 (67.2)	90 (62.5)
No	40 (30.8)	54 (37.5)
Preoperative targeted therapy			0.697
Yes	28 (23.0)	36 (25.0)
No	94 (77.0)	108 (75.0)
CRS score			0.289
1	34 (27.9)	50 (34.7)
2	53 (43.4)	57 (39.6)
3	31 (25.4)	33 (22.9)
4	4 (3.3)	4 (2.8)

TOS: Total open surgery; LHS: Laparoscopic hybrid surgery; CRS: Clinical Risk Score.

Table 2 Pathological data, n (%)/median (interquartile range)

Variable	TOS (n = 122)	LHS (n = 144)	P value
Tumor site			< 0.001
Right colon cancer	73 (59.8)	14 (9.7)
Left colon cancer	22 (18.0)	47 (32.6)
Rectal cancer	27 (10.2)	83 (57.6)
Maximum tumor size, cm
Primary lesion	4.00 (3.00, 6.00)	3.50 (2.50, 5.00)	0.003
Liver metastases	2.98 (1.57, 3.50)	2.98 (1.80, 3.00)	0.843
Differentiation of the primary lesion			0.677
Poor differentiation	28 (23.0)	30 (20.8)
Medium and high differentiation	94 (77.0)	114 (79.2)
Number of lymph nodes	16.00 (13.00, 19.00)	14.00 (11.00, 17.00)	0.001
Liver metastases number			0.936
< 3	113 (92.6)	133 (92.4)
> 3	9 (7.4)	11 (7.6)
pT stage			0.810
0-2	10 (8.2)	13 (9.0)
3-4	112 (91.8)	131 (91.0)
pN stage			0.736
0	45 (36.9)	47 (32.6)
1	54 (44.3)	70 (48.6)
2	23 (18.9)	27 (18.8)
KRAS gene			0.426
Wild-type	73 (59.8)	93 (64.6)
Mutant-type	49 (49.0)	51 (35.4)
BRAF gene			0.062
Wild-type	117 (95.9)	143 (99.3)
Mutant-type	5 (3.4)	1 (0.7)

TOS: Total open surgery; LHS: Laparoscopic hybrid surgery.

Table 3 Complications, n (%)

Variable	TOS (n = 122)	LHS (n = 144)	P value
Overall	25 (20.5)	15 (10.4)	0.022
Gastrointestinal complications
Bowel obstruction	1	1
Anastomotic leakage	7	10
Abdominal infections	1	1
Hepatic complications
Bile leakage	2	0
Subphrenic effusion	8	4
Liver dysfunction	2	2
Respiratory complications
Pleural effusion	15	12
Respiratory dysfunction	11	7
Cardiac complications (heart failure)	4	0
Urinary complications (urinary tract infection)	3	1
General complications
Hemorrhage	11	11
Surgical site infection	15	8
Clavien-Dindo grade I-II	17 (13.9)	9 (6.3)	0.141
Clavien-Dindo grade III-IV	8 (6.6)	6 (4.2)	0.919
Reoperation	0	1 (0.7)	0.356
Mortality	1 (0.8)	0	0.276

Complication subtypes are reported as total number of events; a single patient may have experienced multiple complications. TOS: Total open surgery; LHS: Laparoscopic hybrid surgery.

Table 4 Intraoperative and postoperative outcomes, median (Q1, Q3)/n (%)

Variable	TOS (n = 122)	LHS (n = 144)	P value
Operative time, minutes	240.00 (195.00, 269.00)	260.00 (236.00, 320.00)	< 0.001
Blood loss, mL	500.00 (500.00, 700.00)	300.00 (200.00, 400.00)	< 0.001
Anatomical liver resection			0.858
Yes	21 (17.2)	26 (18.1)
No	101 (82.8)	118 (81.9)
Hepatic portal blockade			0.227
Yes	63 (51.6)	85 (59.0)
No	59 (48.4)	59 (41.0)
Postoperative hospital stay, day	9.00 (8.00, 12.00)	8.00 (6.00, 10.00)	< 0.001
Time of liquid diet, day	4.00 (3.00, 4.00)	3.00 (3.00, 3.00)	< 0.001
Total hospital cost, RMB	55533.20 (48877.66, 64650.19)	66961.83 (60782.02, 74916.50)	< 0.001

TOS: Total open surgery; LHS: Laparoscopic hybrid surgery.