Medium-term surgical outcomes and health-related quality of life after laparoscopic vs open colorectal cancer resection: SF-36 health survey questionnaire

Table 1 Comparison of baseline characteristics between patients receiving laparoscopic resection vs those undergoing open resection

Variables	LR (n = 296)	OR (n = 245)	P value
Gender			0.412
Male	162	135
Female	134	110
Age (mean ± SD)	67.2 ± 11.3	70.1 ± 8.9	0.19
ASA class			0.673
I	162	129
II	111	99
III	23	17
Pre-operative TNM stage			0.342
0	9	5
I	93	71
II	99	80
III	95	89
Tumor location			0.452
Cecum	42	31
Ascending colon	57	45
Transverse colon	33	25
Descending colon	51	42
Sigmoid colon	71	62
Rectum	42	40
Pre-surgery serum CEA level			1.021
< 5 ng/mL	51	34
≥ 5 ng/mL	245	211
Pre-operative CCRT	40	39	0.391
Intervention			0.729
Right hemicolectomy	93	76
Left hemicolectomy	64	45
Transverse colectomy	28	22
Sigmoid colectomy	69	60
Proctectomy	39	38
Abdominal perineal resection	3	4
Protective diversional stoma	13	15
Post-operative TNM stage			0.359
0	9	5
I	92	70
II	96	79
III	99	91
Histopathology			0.637
Well differentiated	112	105
Moderate differentiated	122	93
Poorly differentiated	62	47

ASA: American Society of Anesthesiologists; TNM: Tumor, Node and Metastasis; CEA: CarcinoEmbryonic Antigen; CCRT: Concurrent chemoradiotherapy; LR: Laparoscopic resection; OR: Open resection.

Table 2 Comparison of surgical outcomes between patients receiving laparoscopic resection vs those undergoing open resection

Variables	LR (n = 296)	OR (n = 245)	P value
Lymph nodes removed	15.2 ± 4.5	16.3 ± 5.5	0.067
Hospitalization (days)	11.3 ± 2.5	17.6 ± 5.3	< 0.001c
Operation blood loss (mL)	60.5 ± 21.2	156.2 ± 30.4	< 0.001c
Operation time (min)	182.1 ± 35.2	130.5 ± 21.3	< 0.001c
Peri-operative complications
Total	26	62
Ileus (Grade II)	8	11	0.273
Urinary tract infection (Grade II)	3	14	< 0.001c
Wound infection (Grade I)	4	15	< 0.001c
Pneumonia (Grade II)	5	12	0.048a
Anastomosis leakage (Grade IIIb)	6	10	0.14
Abscess drainage, stoma diversion	2	5	0.231
Recurrence within 1 year	0	2	0.054
Long-term (> 1 year) complications
Incisional hernia (Grade I)	4	7	0.261
Ileus (Grade II)	10	14	0.343

^aP ≤ 0.05;

^cP ≤ 0.001.

Grading of complications is according to the criteria of “Clavien-Dindo classification”. LR: Laparoscopic resection; OR: Open resection.

Table 3 Comparison of Quality of life between patients receiving laparoscopic resection vs those undergoing open resection

Health domains	LR group	OR group	P value
Physical functioning			0.121
Preoperative	91.3 (20.5)	92.7 (23.6)	0.541
3 months after surgery	82.3 (18.0)	65.6 (23.4)	0.006b
6 months after surgery	86.3 (20.4)	84.2 (22.5)	0.399
12 months after surgery	88.3 (14.3)	85.0 (23.0)	0.081
Social functioning			0.113
Preoperative	88.9 (21.8)	86.5 (18.3)	0.213
3 months after surgery	86.5 (20.3)	52.1 (22.0)	0.0001d
6 months after surgery	87.0 (21.0)	60.3 (19.0)	0.001c
12 months after surgery	86.5 (18.3)	83.3 (19.2)	0.321
Vitality			0.749
Preoperative	74.0 (18.5)	74.2 (19.9)	0.983
3 months after surgery	70.9 (14.3)	70.6 (23.2)	0.97
6 months after surgery	72.2 (14.1)	70.3 (15.5)	0.503
12 months after surgery	73.1 (13.8)	72.8 (16.8)	0.675
Mental health			0.553
Preoperative	75.6 (15.1)	78.0 (22.1)	0.631
3 months after surgery	84.5 (12.8)	81.2 (18.7)	0.724
6 months after surgery	84.2 (11.5)	82.6 (14.3)	0.621
12 months after surgery	81.6 (13.5)	82.2 (17.1)	0.827
Role physical			0.112
Preoperative	70.2 (32.1)	68.3 (32.4)	0.734
3 months after surgery	49.7 (33.2)	45.1 (39.2)	0.346
6 months after surgery	70.5 (28.6)	65.6 (32.1)	0.933
12 months after surgery	80.2 (32.4)	77.3 (29.4)	0.192
Role emotional			0.922
Preoperative	81.0 (32.5)	79.1 (29.1)	0.633
3 months after surgery	84.7 (32.4)	81.3 (28.1)	0.21
6 months after surgery	89.2 (24.3)	86.8 (29.1)	0.191
12 months after surgery	90.2 (22.1)	87.6 (28.4)	0.422
Bodily pain			0.315
Preoperative	52.1 (21.3)	55.2 (29.1)	0.937
3 months after surgery	59.3 (22.1)	65.4 (29.6)	0.432
6 months after surgery	63.2 (23.9)	65.1 (22.6)	0.341
12 months after surgery	66.2 (29.2)	62.0 (21.5)	0.653
General health			0.253
Preoperative	66.4 (22.7)	62.8 (19.3)	0.571
3 months after surgery	59.2 (23.1)	49.7 (22.9)	0.045a
6 months after surgery	70.2 (16.3)	67.6 (23.2)	0.31
12 months after surgery	68.7 (23.2)	69.2 (28.1)	0.449
PCS			0.812
Preoperative	71.0 (8.5)	69.1 (10.1)	0.423
3 months after surgery	54.7 (11.4)	43.3 (13.1)	0.021a
6 months after surgery	69.2 (7.3)	67.8 (9.7)	0.592
12 months after surgery	72.2 (12.1)	70.6 (12.4)	0.482
MCS			0.451
Preoperative	69.2 (11.2)	68.4 (8.2)	0.621
3 months after surgery	55.9 (12.8)	49.4 (10.6)	0.015a
6 months after surgery	65.2 (8.4)	61.3 (12.6)	0.414
12 months after surgery	71.2 (14.2)	69.0 (10.3)	0.543
SF-6D			0.513
Preoperative	0.851 (0.142)	0.812 (0.213)	0.571
3 months after surgery	0.732 (0.121)	0.617 (0.149)	0.045a
6 months after surgery	0.781 (0.213)	0.722 (0.192)	0.320
12 months after surgery	0.807 (0.192)	0.781 (0.122)	0.495

^aP ≤ 0.05;

^bP ≤ 0.01;

^cP ≤ 0.001;

^dP ≤ 0.0001.

PCS: Physical component summary; MCS: Mental component summary; SF-6D: Short-form 6 dimension; LR: Laparoscopic resection; OR: Open resection.