Short- and long-term results of open vs laparoscopic multisegmental resection and anastomosis for synchronous colorectal cancer located in separate segments

Table 1 Basic characteristics between laparoscopic group and open group, n (%)

Variable	OMRA group, n = 41	LMRA group, n = 68	P value
Age (yr)
≤ 65	24 (58.5)	31 (45.6)	0.190
> 65	17 (41.5)	37 (54.4)
Gender
Female	14 (34.1)	26 (38.2)	0.668
Male	27 (65.9)	42 (61.8)
ASA physical status			0.058
I-II	33 (80.5)	63 (92.6)
III	8 (19.5)	5 (7.4)
Concomitant diseases
No	19 (46.3)	29 (42.6)	0.707
Yes	22 (53.7)	39 (57.4)
History of abdominal surgery
No	30 (73.2)	56 (82.4)	0.255
Yes	11 (26.8)	12 (17.6)
Preoperative chemotherapy
No	39 (95.1)	68 (100)	0.139
Yes	2 (4.9)	0 (0)
Tumor size1, cm
≤ 5	20 (50.0)	40 (58.8)	0.373
> 5	20 (50.0)	28 (41.2)
Tumor differentiation
Well-moderate	24 (58.5)	32 (47.1)	0.245
Poor	17 (41.5)	36 (52.9)
pT stage
T1-T2	2 (4.9)	7 (10.3)	0.525
T3-T4	39 (95.1)	61 (89.7)
pN stage
N0	16 (39.0)	25 (36.8)	0.915
N1	19 (46.3)	31 (45.6)
N2	6 (14.6)	12 (17.6)
Stage
I	1 (2.4)	6 (8.8)	0.338
II	15 (36.6)	19 (27.9)
III	25 (61.0)	43 (63.2)
CEA
≤ 5	19 (46.3)	31 (45.6)	0.929
> 5	13 (31.7)	20 (29.4)
Unknown	9 (22.0)	17 (25.0)
CA199
≤ 37	28 (68.3)	42 (61.8)	0.696
> 37	3 (7.3)	9 (13.2)
Unknown	10 (24.4)	17 (25.0)
Postoperative chemotherapy
No	20 (48.8)	30 (44.1)	0.636
Yes	21 (51.2)	38 (55.9)

¹Unknown for one patient.

OMRA: Open multisegmental resection and anastomosis; LMRA: Laparoscopic multisegmental resection and anastomosis; CA19-9: Carbohydrate antigen 19-9; CEA: Carcinoembryonic antigen; ASA: American Society of Anesthesiologists.

Table 2 Surgical results between laparoscopic group and open group

Variable	OMRA group, n = 41	LMRA group, n = 68	P value
Operative time (min)	253.0 ± 101.9	274.0 ± 83.4	0.244
Blood loss (mL)	200 (30-600)	100 (20-600)	0.006
Time to first exhaust (d)	3 (1-6)	2 (1-4)	0.001
Time to first liquid diets (d)	4 (2-9)	3 (2-6)	0.012
Postoperative complications (Grade Ⅱ-V)	7 (17.1)	2 (2.9)	0.025
Ileus	2 (4.9)	0 (0.0)	0.139
Anastomotic leakage	3 (7.3)	2 (2.9)	0.558
Cerebral infarction	1 (2.4)	0 (0.0)	0.376
Abdominal incision infection	1 (2.4)	0 (0.0)	0.376
No. of retrieved lymph nodes	37.3 ± 17.1	45.2 ± 16.8	0.020
No. of positive lymph nodes	1 (0-13)	1 (0-15)	0.542
Mortality	0 (0)	0 (0)	1.000
Postoperative hospital stay, median, range, days	12 (7-34)	9 (3-30)	0.002

OMRA: Open multisegmental resection and anastomosis; LMRA: Laparoscopic multisegmental resection and anastomosis.

Table 3 Univariate and multivariate analysis of overall survival and disease-free survival

Variable	Overall survival				Disease-free survival
	Univariable analysis		Multivariate analysis		Univariable analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value
Age (> 65/≤ 65 yr)	2.830 (0.983-8.150)	0.054	2.378 (0.793-7.128)	0.122	2.048 (0.779-5.384)	0.146	1.869 (0.674-5.188)	0.230
Gender (male/female)	1.051 (0.382-2.894)	0.923			1.180 (0.436-3.191)	0.744
CEA level (> 5/≤ 5)	1.278 (0.389-4.198)	0.686			1.098 (0.348-3.465)	0.873
CA19-9 level (> 37/≤ 37)	1.951 (0.506-7.521)	0.332			1.304 (0.285-5.958)	0.732
ASA physical status (III/I-II)	2.565 (0.817-8.050)	0.106			2.280 (0.655-7.940)	0.195
Tumor differentiation (poor/well- moderate)	0.918 (0.340-2.478)	0.866			1.119 (0.431-2.906)	0.817
Tumor size (> 5/≤ 5 cm)	1.058 (0.383-2.920)	0.913			0.863 (0.328-2.269)	0.764
T stage (T3-T4/T1-T2)	0.994 (0.130-7.627)	0.994			1.302 (0.172-9.854)	0.798
N stage (N1-N2/N0)	11.266 (1.487-85.384)	0.019	10.161 (1.327-77.790)	0.026	13.414 (1.775-101.359)	0.012	13.107 (1.719-99.925)	0.013
Operative approach (LMRA/OMRA)	1.240 (0.426-3.611)	0.693	0.834 (0.274-2.534)	0.749	1.233 (0.432-3.516)	0.695	0.812 (0.269-2.454)	0.712

OMRA: Open multisegmental resection and anastomosis; LMRA: Laparoscopic multisegmental resection and anastomosis; CA19-9: Carbohydrate antigen 19-9; CEA: Carcinoembryonic antigen; ASA: American Society of Anesthesiologists; HR: Hazard ratio; CI: Confidence interval.