Comparing the Outcomes of Laparoscopic and Open Resections of Colorectal Cancer

Comparing the Outcomes of Laparoscopic and Open Resections of Colorectal Cancer | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparing the Outcomes of Laparoscopic and Open Resections of Colorectal Cancer Hugh Kolomar, Shireen Rahmani, Mariia Khomchenko, Mujahed Dalain This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6673998/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: Surgical resection of non-metastatic colorectal adenocarcinoma remains the gold standard treatment. Laparoscopy offers various advantages over the open surgical modality. However, the adoption of laparoscopy in different countries is slow because of the associated learning curve and the apprehension around the integrity of the resection margin. Aim: To compare short-term outcomes of laparoscopic and open resections for colorectal cancer performed in a single institution. Materials and Methods: This study retrospectively analyzed the medical records of 99 consecutive patients who underwent elective resection for adenocarcinoma of the colon and rectum. Patients were divided into two groups, the open surgery group and the laparoscopic group, then matched into 30 pairs using a propensity score. Variables compared between the groups were demographics, tumor localization, type of resection, 30-day postoperative outcome, number of lymph nodes, length of resected specimens, distal margins, tumor T stage, and TNM stage. Results: Compared to open surgery, laparoscopy resulted in significantly shorter hospital stays and reduced complications, particularly infections (p 0.05). Conclusion: The results suggest that patients who underwent laparoscopic resection experienced significant improvements in the first 30 days postoperatively when compared to patients who underwent open resection. Patients in the laparoscopy group had fewer complications, a faster postoperative recovery, and a shorter hospital stay than patients in the open group, while adhering to oncological resection principles. Colorectal Adenocarcinoma Laparoscopic Resections Minimally Invasive Surgery Open resections Propensity Score Laparotomy Introduction Colorectal cancer (CRC) is the second leading cause of cancer-specific mortality and the third most common cancer worldwide [1]. Histologically, over 95% of all cases are colorectal adenocarcinoma (CA) [2]. During the early stages, patients may be asymptomatic or may experience non-specific symptoms. As the disease progresses, patients experience changes in bowel habits, rectal bleeding, and abdominal pain. For the management of CRC, it’s necessary to identify the disease’s stage. Surgeons can treat patients in the initial localized non-metastatic stage with curative surgery. For patients with advanced-stage cancer, palliative surgery could help improve the patient’s quality of life by mitigating severe complications caused by tumor growth, like mechanical obstruction of the intestine [3]. Open and laparoscopic resections are the most common surgical procedures, while robotic and trans-anal methods remain novel. Although the number of laparoscopically performed surgeries is increasing, the open approach remains more common despite the proven advantages of minimally invasive surgery [4]. Laparoscopic colorectal resection is an intricate procedure that is more technically and manually demanding and requires specialized instruments. Many countries have adopted laparoscopy as the gold standard for resecting most CRC cases, while other countries remain hesitant to do so. Laparoscopy results in faster recovery times and a lower incidence of complications, which benefits both patients and the healthcare system [2]. Despite the higher risk of postoperative infections and small bowel obstruction, open resections are still performed due to concerns about the integrity of the resection margin after laparoscopic procedures. [5] Aim: This paper will compare short-term results of open and laparoscopic resections of the colon and/or rectal cancer from 99 patients within a single institute. It analyzes post-operative outcomes, including recovery after resections, length of hospitalization and the number of post-operative morbidities and mortalities. Materials and Methods This retrospective study included outcome data of 99 consecutive operations that were performed for the sole purpose of resecting adenocarcinoma of the colon and rectum in patients over a period of nine months (March - December 2023) at the Clinic for Digestive Surgery, University Clinical Center in Niš. The data was obtained from the Heliant electronic database. This research only included patients with proven adenocarcinoma of the colon and rectum who underwent curative resections in elective conditions. The analysis excluded patients with multi-visceral resections, dysplastic polyps, emergency operations, recurrences, metastatic disease, or other histological types of colon and rectal tumors. The same colorectal surgical team, using consistent preoperative, oncological, and postoperative protocols, performed all patient operations. An accelerated recovery protocol was not implemented regardless of the approach (laparoscopic or open). The decision on the operative approach was made depending on the preference of the prescribing surgeon and technical expertise. Patients were divided into two groups: laparoscopic and open. The following parameters were analyzed: demographic data, comorbidities, tumor localization, type of resection, T stage, and tumor stage. Short-term outcomes during the first 30 days after surgery were compared: duration of hospitalization, mortality, and complications. The quality of surgery was compared by measuring the length of the preparation after resection, the number of analyzed lymph nodes, and the distal margin in rectal cancer. A propensity score was calculated for each patient using a logistic regression model. Both R project version 4.3.3 and SPSS program version 29.0.2 were used for statistical analysis in this study. Patients of the same age, gender, comorbidities, tumor location, and stage (dependent variables) but undergoing different surgical modalities (independent variables) were optimally matched. 30 patients were matched to the open group and 30 patients to the laparoscopic group. Mean values of the mentioned parameters were analyzed using paired and unpaired Student T-tests before and after. For parameters with frequencies, the chi-square test was used. Statistical significance was determined at the p< 0.05 level. Results The comparison results of the two groups of patient’s demographics and co-morbidities are shown below in Table 1 . Patients who underwent the open surgical modality accounted for 70% of the patients in this study and were placed in the open group, while patients who underwent the laparoscopic surgical modality accounted for 30% and were placed in the laparoscopic group. Patients ages, genders and their co-morbidities were all analyzed and compared. None of the Table 1 variables showed significant differences (as they all had P values > 0.05). 64% and 60% of co-morbidities in the open surgery group and laparoscopic group respectively were cardiovascular. Table -1- Demographics and co-morbidities of the patients Before Matching After Matching Open Laparoscopic P value Open Laparoscopic P value Number of patients 69 (70) 30 (30) 30 (50) 30 (50) Age (mean ± SD) 67 ± 11.2 69.8 ± 9.5 0.24 (NS) 71.2 ± 8.1 69.8 ± 9.5 0.54 (NS) Gender (male: female) 14:9 2:1 0.58 (NS) 7:3 2:1 0.08 (NS) Co-morbidities: NS NS Cardiovascular 44 (64) 18 (60) 26 (87) 18 (60) Pulmonological 2 (3) 1 (3) 2 (7) 1 (3) Endocrinological 7 (10) 8 (27) 6 (20) 8 (27) NS= Not significant Most common localization of adenocarcinoma in both groups is the rectum (53% and 63%). In both groups, over two-thirds of the patients had stage T3 disease at the time of surgery. There was no statistically significant difference between groups in terms of tumor localization, T stage, overall stage (Table 2 ). Table -2- Location of adenocarcinoma in the patients Before Matching After Matching Open 69 (70) Laparoscopic 30 (30) P value Open 30 (50) Laparoscopic 30 (50) P value Tumour distribution: (NS) 0.43 (NS) Cecum 13 (19) (13) 2 (7) 4 (13) Ascending 4 (6) 0 3 (10) 0 Transverse 5 (7) 0 1 (3) 0 Hepatic Flexure 1 (1) 0 1 (3) 0 Lienal Flexure 3 (4) 0 1 (3) 0 Descending 1 (1) 1 (3) 1 (3) 1 (3) Sigmoid 10 (14) 6 (20) 6 (20) 6 (20) Rectum 32 (46) 19 (63) 16 (53) 19 (63) Tumour Stage: (NS) 0.76 (NS) 0 2 (3) 0 1 (3) 0 I 9 (13) 3 (10) 5 (17) 3 (10) II 2 (3) 1 (3) 1 (3) 1 (3) II A 22 (32) 13 (43) 12 (40) 13 (43) II B 4 (6) 3 (10) 1 (3) 3 (10) III A 2 (3) 1 (3) 2 (7) 1 (3) III B 22 (32) 6 (6) 7 (23) 6 (20) III C 6 (9) 3 (10) 1 (3) 3 (10) T Stage: 0.24 (NS) 0.16 (NS) Tis 2 (3) 0 1 (3) 0 T1 2 (3) 1 (3) 1 (3) 1 (3) T2 9 (13) 4 (13) 6 (20) 4 (13) T3 47 (68) 25 (83) 18 (60) 25 (83) T4 9 (13) 0 4 (13) 0 NS= Not significant There was no statistical difference in the different types of colonic and rectal resections between the groups, p> 0.05 (Table 3 ). The most frequently performed operation in open surgery is the right hemicolectomy 26%. Meanwhile, in the laparoscopic approach, high resection of the rectum is the most common in 40% of cases. Table -3- Type of Resections Open 69 (70) Laparoscopic 30 (30) P value Operation: 0.28 (NS) APR (Abdominoperineal) 3 (4) 2 (7) Hartmann Procedure 5 (7) 0 Right Hemicolectomy 18 (26) 4 (13) Extended Right Hemicolectomy 5 (7) 0 Left Hemicolectomy 7 (10) 2 (7) RRAI (Lower Anterior) 14 (20) 9 (30) RRAS (Superior Rectal) 16 (23) 12 (40) Sigmoid Resection 1 (1) 1 (3) NS= Not significant According to patho-histological reports, surgeons achieved R0 resection in all patients. A resection designated as R0 denotes a microscopically margin-negative resection, meaning that the primary tumor bed is free of any remaining microscopic or gross tumor. Table 4 compares the quality of resection by analyzing the parameters obtained from the resections, specifically: the length of the resected segment, the number of lymph nodes, and the distal margin for rectal carcinomas. There was no statistically significant difference in any of the analyzed parameters between the laparoscopic and open groups (p> 0.05). Table -4- Resections characteristics Before Matching After Matching Open 69 (70) Laparoscopic 30 (30) P value Open 30 (50) Laparoscopic 30 (50) P value Distal Margin – Rectal cancer only (mean ± SD) 1.9 ± 1.5 2.1 ± 1.9 0.76 (NS) 1.8 ± 1.4 2.1 ± 1.9 0.49 (NS) Length of resection (mean ± SD) 21.8 ± 8.9 22.1 ± 7.4 0.73 (NS) 20.3 ± 7.6 22.1 ± 7.4 0.35 (NS) Number of lymph nodes excised (mean ± SD) 15.8 ± 7.3 18.4 ± 8.4 0.17 (NS) 14.6 ± 7.4 18.4 ± 8.4 0.069 (NS) NS= Not significant Patients operated by a laparoscopic approach had a statistically significant shorter hospital stay after surgery (p<0.05). Regarding complications after surgery, after pairing, 15 patients in total developed complications, 37% were in the open surgery group and 13% were in the laparoscopic group. Postoperative infection is considerably higher in the open surgery group, at 13%, compared to the rest of the postoperative complications in that group, as stated in Table 5 . Table -5- Postoperative data Before Matching After Matching Open 69 (70) Laparoscopic 30 (30) P value Open 30 (50) Laparoscopic 30 (50) P value Length of hospital stay after surgery (mean ± SD) 8.8 ± 4.51 6.73 ± 0.98 0.015 (S) 9.4 ± 5.61 6.73 ± 0.98 0.014 (S) Post-operative morbidities: 20 (29) 4 (13) 11(37) 4 (13) Incision infection 8 (12) 1 (3) 4 (13) 1 (3) Leakage 2 (3) 0 1 (3) 0 Post-operative ileus 5 (7) 2 (7) 3 (10) 2 (7) Pulmonological complications 3 (4) 1 (3) 1 (3) 1 (3) Death 2 (3) 0 2 (7) 0 NS= Not significant Discussion The study included 99 consecutive patients with adenocarcinoma of the colon and rectum operated on by laparoscopic or open technique during a period of nine months. According to the analyzed results, there was no statistically significant difference between these two groups in terms of age, gender, comorbidity, or disease stage. These results are expected, particularly following a period of mastering laparoscopic resection; the choice of surgical modality should therefore no longer be affected by any of the aforementioned parameters. The patients were more often men, older than 65 years, which is in line with the disease trends in the world [6]. According to GLOBOCAN (2020), the incidence of CRC is almost four times higher in developing countries than in developed countries, while the mortality rate does not vary greatly. Western Europe has one of the highest CRC rates, but considering socioeconomic development and lifestyle changes, an increase in the number of patients is expected in Southeast Europe. Screening programs have led to fewer advanced CRC cases in some countries, but this is offset by a concerning 1-4% annual rise in CRC incidence among those under 50, counteracting a positive trend observed among those aged 50 and over [6]. There was no statistically significant difference between the groups in terms of cancer stages. The cancer stage was expected to influence the choice of surgical approach, as no patient undergoing laparoscopic surgery in the analyzed sample had a T4 stage. Laparoscopy is relatively contraindicated in T4 CRC resections as these tumors usually require multi-visceral resections, which are generally challenging using laparoscopy [7]. Pre- and post-matching comparisons of patho-histological variables (lymph node count, specimen length, resection margin) revealed no statistically significant difference in outcomes between laparoscopic and open surgeries. This confirms that in the center where the research was conducted, the laparoscopic technique in the treatment of CRC is completely equivalent to oncological open surgery. Similar results are published in a study by Dr. Kockerling where the resection margins of the preparations were analyzed, though he observed some variations in relation to the surgeon’s experience [8]. All the patients in this study were operated on by the same group of surgeons with over ten years of experience in colorectal surgery. Hospital stays and complication rates are significantly lower after laparoscopic surgery than after open surgery (p < 0.05). This is one key advantage of the laparoscopic technique. A shorter post-operative stay is the result of faster recovery and without the implementation of the accelerated recovery protocol, which was not applied regardless of the operative approach. The number of complications is five times higher in the open group. After matching, this difference is reduced to 2.75 times, which may indicate a conscious selection of high-risk patients for open surgery. Surgical site infection is the most common complication in open surgery, which is expected given the length of the surgical incision. These results are in line with a study published in BMC Surgery, which also compared the short-term and long-term outcomes of open surgery and laparoscopic surgery in patients with colorectal cancer. According to the study, patients undergoing laparoscopic resection for CRC have a statistically significant shorter hospital stay and similar results to the open modality in terms of postoperative mortality and morbidity. Long-term survival, cancer-specific survival, and recurrence rates were similar in both cohorts [9]. Another study emphasized the feasibility of laparoscopy, especially for elderly patients with CRC. According to their results, laparoscopy has a shorter hospitalization and similar long-term results with an acceptable conversion rate that did not affect long-term results [10]. The shortcoming of our study is the absence of long-term follow-up of patients for a better comparison. However, an advantage of our study is having completed a propensity score optimal matching, after which identical results were obtained. Despite numerous studies indicating the advantages of laparoscopic surgery over traditional open surgery [2, 4, 11, 12], its implementation in the surgical treatment of colorectal cancer has been relatively slow. This stems from the laparoscopic technique’s intricate nature, requiring specialized skills and extensive experience [13]. Limitations of this study include a lack of long-term follow-up, a few patients, and non-randomized selection. Moreover, this study is retrospective, which, though valuable in some contexts, is often less reliable than prospective studies because it uses past data that may lead to inaccurate conclusions. Because these resections were for treating patients and were not pre-designed to be part of a research, researchers did not record the analyzed data consistently. Despite these drawbacks, retrospective studies have their place in science because they are quick, cheap, and easy to perform, and as such, are ideal for preliminary research [14]. Furthermore, different surgeons performed the interventions, leading to less consistent operation results and variability bias. Moreover, one key attribute any scientific research should have is replicability. If multiple surgeons performed, other researchers might find it difficult to replicate the study, which can call into question the validity of the results [15, 16]. On the other hand, all the surgeons who participated in this research are part of the same surgical team and follow identical standards of care in terms of preoperative surgery, oncological resection, and postoperative treatment and follow-up. Conclusion This study confirms that laparoscopic and open surgery yield comparable short-term oncological results in colorectal cancer treatment; however, laparoscopic surgery provides better postoperative recovery. Patient’s overall health, surgeon’s expertise, disease progression, and available resources all play a role in deciding between laparoscopic and open surgical techniques. Optimal oncological resection, including dissecting adequate lymph nodes number and clear resection margin, was the primary surgical goal, irrespective of the technique used. Declarations Niš medical faculty ethical committee waived the need for consent or IRB. Data was anonymized data provided by the University for this retrospective study. Funding Statement - None Ethics Statement - Human Ethics and Consent to Participate declarations - not applicable; a retrospective study, patients came for the sole purpose of treating their colorectal carcinoma and not to be part of this study. Data was collected during / after their surgeries for documentations purposes only Conflict of Interest Statement - none References Bedirli A, Salman B, Yuksel O: Laparoscopic versus Open Surgery for Colorectal Cancer: A Retrospective Analysis of 163 Patients in a Single Institution. Minimally Invasive Surgery. 2014, 1-6. 10.1155/2014/530314 World Health Organization: WHO, World Health Organization: WHO. Colorectal cancer, Available from: https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer. https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer.. Currais P, Rosa I, Claro I: Colorectal cancer carcinogenesis: From bench to bedside. World Journal of Gastrointestinal Oncology. 14. 10.4251/wjgo.v14.i3.654 Milone M, Manigrasso M, Burati M, et al.: Surgical resection for rectal cancer. Is laparoscopic surgery as successful as open approach? A systematic review with meta-analysis. PLoS ONE. 13. 10.1371/journal.pone.0204887 Bonjer HJ, Deijen CL, Abis GA, et al.: A Randomized Trial of Laparoscopic versus Open Surgery for Rectal Cancer. New England Journal of Medicine. 372. 10.1056/NEJMoa1414882 Sung H, Ferlay J, Siegel RL, et al.: Global Cancer Statistics. 2024. 10.3322/caac.21834 Klaver CEL, Kappen TM, Borstlap W a. A, et al.: Laparoscopic surgery for T4 colon cancer: a systematic review and meta-analysis. Surgical Endoscopy. 31. 10.1007/s00464-017-5544-7 Köckerling F, Reymond MA, Schneider C, et al.: Prospective multicenter study of the quality of oncologic resections in patients undergoing laparoscopic colorectal surgery for cancer. Diseases of the Colon & Rectum. 41. 10.1007/BF02237381 Chern Y-J, Hung H-Y, You J-F, et al.: Advantage of laparoscopy surgery for elderly colorectal cancer patients without compromising oncologic outcome. BMC Surgery. 20. 10.1186/s12893-020-00967-6 Zhou S, Wang X, Zhao C, et al.: Laparoscopic vs open colorectal cancer surgery in elderly patients: short- and long-term outcomes and predictors for overall and disease-free survival. BMC Surgery. 19. 10.1186/s12893-019-0596-3 Buunen M, Veldkamp R, Hop WCJ, et al.: Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. The. Lancet Oncology. 10. 10.1016/S1470-2045(08)70310-3 Beckmann K, Moore J, Wattchow D, et al.: Short‐term outcomes after surgical resection for colorectal cancer in South Australia. Journal of Evaluation in Clinical Practice. 23. 10.1111/jep.12612 Kelly M, Bhangu A, Singh P, et al.: Systematic review and meta-analysis of trainee- versus expert surgeon-performed colorectal resection. British Journal of Surgery. 101. 10.1002/bjs.9472 Berndt AE: Sampling methods. Journal of Human Lactation. 36. 10.1177/0890334420906850 Bobbitt Z. (Standardized vs. Unstandardized Regression Coefficients). Accessed: 09/11/2024: https://www.statology.org/standardized-vs-unstandardized-regression-coefficients/. Menard S: Six approaches to calculating Standardized logistic regression coefficients. The American Statistician. 58. 10.1198/000313004X946 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6673998","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":515229180,"identity":"2de81d2f-1ac4-4ec0-be82-fd3c40176055","order_by":0,"name":"Hugh Kolomar","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5klEQVRIiWNgGAWjYBACAwYGNgaGAwwyYN4HIItoLTwgDuMMiBbGBqK1MPMQo8VcIv3aA4YzNjz8YoeffbbdcceeQbr5+AN8Wixn5JQbMNxI45GcnWY8O/fMs8QGmWOJ+B12IydNguHDYR6D2wnGzLlthxMYJHIMidWS/pnZsu2wPYNE/kcCWtKPSTDcAGnJMWZmbDvM2CCRQyDEzrxhk0g4A/JLTjFjb9vhxDaJNMMZeLUcT38m8eGYjRy/dPpmhp9Ah/FLJD/4gE8LAwOPAUMCMp8Nv3IQYH9AWM0oGAWjYBSMbAAA8y1MkGwIxS4AAAAASUVORK5CYII=","orcid":"","institution":"Clinical Centre of Niš","correspondingAuthor":true,"prefix":"","firstName":"Hugh","middleName":"","lastName":"Kolomar","suffix":""},{"id":515229181,"identity":"e8237cca-3a3b-48f5-b178-cd798d989b00","order_by":1,"name":"Shireen Rahmani","email":"","orcid":"","institution":"Clinical Centre of Niš","correspondingAuthor":false,"prefix":"","firstName":"Shireen","middleName":"","lastName":"Rahmani","suffix":""},{"id":515229182,"identity":"b63b25e0-c75b-436a-9fea-61e3914366d3","order_by":2,"name":"Mariia Khomchenko","email":"","orcid":"","institution":"Charles University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Mariia","middleName":"","lastName":"Khomchenko","suffix":""},{"id":515229183,"identity":"55334fc0-5749-4df8-bfba-d4b9bb7514d6","order_by":3,"name":"Mujahed Dalain","email":"","orcid":"","institution":"Pauls Stradins Clinical University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Mujahed","middleName":"","lastName":"Dalain","suffix":""}],"badges":[],"createdAt":"2025-05-15 15:23:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6673998/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6673998/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":92011499,"identity":"dc529f72-925b-4353-b5ff-5114554db0f8","added_by":"auto","created_at":"2025-09-23 15:44:58","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":955917,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6673998/v1/a4c9e45a-e506-4c25-800e-4369c7cf5365.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparing the Outcomes of Laparoscopic and Open Resections of Colorectal Cancer","fulltext":[{"header":"Introduction","content":"\u003cp\u003eColorectal cancer (CRC) is the second leading cause of cancer-specific mortality and the third most common cancer worldwide [1]. Histologically, over 95% of all cases are colorectal adenocarcinoma (CA) [2]. During the early stages, patients may be asymptomatic or may experience non-specific symptoms. As the disease progresses, patients experience changes in bowel habits, rectal bleeding, and abdominal pain. For the management of CRC, it\u0026rsquo;s necessary to identify the disease\u0026rsquo;s stage. Surgeons can treat patients in the initial localized non-metastatic stage with curative surgery. For patients with advanced-stage cancer, palliative surgery could help improve the patient\u0026rsquo;s quality of life by mitigating severe complications caused by tumor growth, like mechanical obstruction of the intestine [3].\u003c/p\u003e\n\u003cp\u003eOpen and laparoscopic resections are the most common surgical procedures, while robotic and trans-anal methods remain novel. Although the number of laparoscopically performed surgeries is increasing, the open approach remains more common despite the proven advantages of minimally invasive surgery [4]. Laparoscopic colorectal resection is an intricate procedure that is more technically and manually demanding and requires specialized instruments. Many countries have adopted laparoscopy as the gold standard for resecting most CRC cases, while other countries remain hesitant to do so. Laparoscopy results in faster recovery times and a lower incidence of complications, which benefits both patients and the healthcare system [2]. Despite the higher risk of postoperative infections and small bowel obstruction, open resections are still performed due to concerns about the integrity of the resection margin after laparoscopic procedures. [5] \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eAim: \u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis paper will compare short-term results of open and laparoscopic resections of the colon and/or rectal cancer from 99 patients within a single institute. It analyzes post-operative outcomes, including recovery after resections, length of hospitalization and the number of post-operative morbidities and mortalities.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eThis retrospective study included outcome data of 99 consecutive operations that were performed for the sole purpose of resecting adenocarcinoma of the colon and rectum in patients over a period of nine months (March - December 2023) at the Clinic for Digestive Surgery, University Clinical Center in Niš. The data was obtained from the Heliant electronic database. This research only included patients with proven adenocarcinoma of the colon and rectum who underwent curative resections in elective conditions. The analysis excluded patients with multi-visceral resections, dysplastic polyps, emergency operations, recurrences, metastatic disease, or other histological types of colon and rectal tumors.\u003c/p\u003e\n\u003cp\u003eThe same colorectal surgical team, using consistent preoperative, oncological, and postoperative protocols, performed all patient operations. An accelerated recovery protocol was not implemented regardless of the approach (laparoscopic or open). The decision on the operative approach was made depending on the preference of the prescribing surgeon and technical expertise. Patients were divided into two groups: laparoscopic and open. The following parameters were analyzed: demographic data, comorbidities, tumor localization, type of resection, T stage, and tumor stage. Short-term outcomes during the first 30 days after surgery were compared: duration of hospitalization, mortality, and complications. The quality of surgery was compared by measuring the length of the preparation after resection, the number of analyzed lymph nodes, and the distal margin in rectal cancer.\u003c/p\u003e\n\u003cp\u003eA propensity score was calculated for each patient using a logistic regression model. Both R project version 4.3.3 and SPSS program version 29.0.2 were used for statistical analysis in this study. Patients of the same age, gender, comorbidities, tumor location, and stage (dependent variables) but undergoing different surgical modalities (independent variables) were optimally matched. 30 patients were matched to the open group and 30 patients to the laparoscopic group. Mean values of the mentioned parameters were analyzed using paired and unpaired Student T-tests before and after. For parameters with frequencies, the chi-square test was used. Statistical significance was determined at the p\u0026lt; 0.05 level.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe comparison results of the two groups of patient\u0026rsquo;s demographics and co-morbidities are shown below in Table \u003ca href=\"javascript%3Avoid(0)\"\u003e\u003cem\u003e1\u003c/em\u003e\u003c/a\u003e. Patients who underwent the open surgical modality accounted for 70% of the patients in this study and were placed in the open group, while patients who underwent the laparoscopic surgical modality accounted for 30% and were placed in the laparoscopic group. Patients ages, genders and their co-morbidities were all analyzed and compared. None of the Table \u003ca href=\"javascript%3Avoid(0)\"\u003e\u003cem\u003e1\u003c/em\u003e\u003c/a\u003e variables showed significant differences (as they all had P values \u0026gt; 0.05). 64% and 60% of co-morbidities in the open surgery group and laparoscopic group respectively were cardiovascular.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable -1-\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eDemographics and co-morbidities of the patients\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"634\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBefore Matching\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter Matching\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOpen\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaparoscopic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOpen\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaparoscopic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of patients\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e69 (70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e30 (30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e30 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e30 (50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (mean \u0026plusmn; SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e67 \u0026plusmn; 11.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e69.8 \u0026plusmn; 9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.24 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e71.2 \u0026plusmn; 8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e69.8 \u0026plusmn; 9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.54 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender (male: female)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e14:9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e2:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.58 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e7:3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e2:1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.08 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCo-morbidities:\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003e\n \u003cp\u003eCardiovascular\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e44 (64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e18 (60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e26 (87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e18 (60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003e\n \u003cp\u003ePulmonological\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e2 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e2 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 187px;\"\u003e\n \u003cp\u003eEndocrinological\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e7 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e8 (27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e8 (27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNS= Not significant\u003c/p\u003e\n\u003cp\u003eMost common localization of adenocarcinoma in both groups is the rectum (53% and 63%). In both groups, over two-thirds of the patients had stage T3 disease at the time of surgery. There was no statistically significant difference between groups in terms of tumor localization, T stage, overall stage (Table \u003ca href=\"javascript%3Avoid(0)\"\u003e\u003cem\u003e2\u003c/em\u003e\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable -2-\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eLocation of adenocarcinoma in the patients\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"654\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBefore Matching\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter Matching\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOpen\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e69 (70)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaparoscopic\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e30 (30)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOpen\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e30 (50)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaparoscopic\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e30 (50)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTumour distribution:\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003col start=\"0\"\u003e\n \u003cli\u003e(NS)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.43 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Cecum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e13 (19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003col start=\"4\"\u003e\n \u003cli\u003e(13)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e2 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e4 \u0026nbsp;(13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Ascending\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e4 \u0026nbsp;(6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Transverse\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e5 \u0026nbsp;(7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Hepatic Flexure\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1 \u0026nbsp;(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Lienal Flexure\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e3 \u0026nbsp;(4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Descending\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1 \u0026nbsp;(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1 \u0026nbsp;(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Sigmoid\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e10 (14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e6 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e6 \u0026nbsp;(20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Rectum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e32 (46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e19 (63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e16 (53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e19 \u0026nbsp;(63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTumour Stage:\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003col start=\"0\"\u003e\n \u003cli\u003e(NS)\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.76 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e2 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;I\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e9 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e5 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;II\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e2 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e1 \u0026nbsp;(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1 \u0026nbsp;(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;II A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e22 (32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e13 (43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e12 (40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e13 \u0026nbsp; (43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;II B\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e4 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e1 \u0026nbsp;(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e3 \u0026nbsp;(10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;III A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e2 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e2 \u0026nbsp;(7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1 \u0026nbsp; (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;III B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e22 (32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e6 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e7 \u0026nbsp;(23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e6 \u0026nbsp; (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;III C\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e6 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e1 \u0026nbsp;(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e3 \u0026nbsp; (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT Stage:\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.24 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.16 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Tis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e2 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e1 \u0026nbsp;(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;T1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e2 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e1 \u0026nbsp;(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1 \u0026nbsp;(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003eT2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e9 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e4 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e6 \u0026nbsp;(20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e4 \u0026nbsp; (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003eT3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e47 (68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e25 (83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e18 (60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e25 \u0026nbsp;(83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003eT4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e9 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e4 \u0026nbsp;(13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNS= Not significant\u003c/p\u003e\n\u003cp\u003eThere was no statistical difference in the different types of colonic and rectal resections between the groups, p\u0026gt; 0.05 (Table\u0026nbsp;\u003ca href=\"javascript%3Avoid(0)\"\u003e\u003cem\u003e3\u003c/em\u003e\u003c/a\u003e). The most frequently performed operation in open surgery is the right hemicolectomy 26%. Meanwhile, in\u0026nbsp;the laparoscopic approach, high resection of the rectum is the most common in 40% of cases.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable -3-\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eType of Resections\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 306px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOpen\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e69 (70)\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaparoscopic\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e30 (30)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 306px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOperation:\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e0.28 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 306px;\"\u003e\n \u003cp\u003eAPR (Abdominoperineal)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e3 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e2 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 306px;\"\u003e\n \u003cp\u003eHartmann Procedure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e5 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 306px;\"\u003e\n \u003cp\u003eRight Hemicolectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e18 (26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e4 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 306px;\"\u003e\n \u003cp\u003eExtended Right Hemicolectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e5 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 306px;\"\u003e\n \u003cp\u003eLeft Hemicolectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e7 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e2 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 306px;\"\u003e\n \u003cp\u003eRRAI (Lower Anterior)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e14 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e9 (30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 306px;\"\u003e\n \u003cp\u003eRRAS (Superior Rectal)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e16 (23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e12 (40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 306px;\"\u003e\n \u003cp\u003eSigmoid Resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e1 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNS= Not significant\u003c/p\u003e\n\u003cp\u003eAccording to patho-histological reports, surgeons achieved R0 resection in all patients. A resection designated as R0 denotes a microscopically margin-negative resection, meaning that the primary tumor bed is free of any remaining microscopic or gross tumor. Table \u003ca href=\"javascript%3Avoid(0)\"\u003e\u003cem\u003e4\u003c/em\u003e\u003c/a\u003e compares the quality of resection by analyzing the parameters obtained from the resections, specifically: the length of the resected segment, the number of lymph nodes, and the distal margin for rectal carcinomas. There was no statistically significant difference in any of the analyzed parameters between the laparoscopic and open groups (p\u0026gt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable -4-\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eResections characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"627\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 182px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBefore Matching\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter Matching\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 182px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOpen\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e69 (70)\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaparoscopic\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e30 (30)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOpen\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e30 (50)\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaparoscopic\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e30 (50)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 182px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDistal Margin \u0026ndash; Rectal cancer only (mean \u0026plusmn; SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e1.9 \u0026plusmn; 1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e2.1 \u0026plusmn; 1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.76 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e1.8 \u0026plusmn; 1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e2.1 \u0026plusmn; 1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.49 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 182px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLength of resection (mean \u0026plusmn; SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e21.8 \u0026plusmn; 8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e22.1 \u0026plusmn; 7.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.73 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e20.3 \u0026plusmn; 7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e22.1 \u0026plusmn; 7.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.35 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 182px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of \u0026nbsp;lymph nodes excised (mean \u0026plusmn; SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e15.8 \u0026plusmn; 7.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e18.4 \u0026plusmn; 8.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.17 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e14.6 \u0026plusmn; 7.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e18.4 \u0026plusmn; 8.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.069 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNS= Not significant\u003c/p\u003e\n\u003cp\u003ePatients operated by a laparoscopic approach had a statistically significant shorter hospital stay after surgery (p\u0026lt;0.05). Regarding complications after surgery, after pairing, 15 patients in total developed complications, 37% were in the open surgery group and 13% were in the laparoscopic group. Postoperative infection is considerably higher in the open surgery group, at 13%, compared to the rest of the postoperative complications in that group, as stated in Table\u0026nbsp;\u003ca href=\"javascript%3Avoid(0)\"\u003e\u003cem\u003e5\u003c/em\u003e\u003c/a\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable -5-\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ePostoperative data\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"618\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBefore Matching\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAfter Matching\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOpen\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e69 (70)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaparoscopic\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e30 (30)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOpen\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e30 (50)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaparoscopic\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e30 (50)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLength of hospital stay after surgery (mean \u0026plusmn; SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e8.8 \u0026plusmn; 4.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e6.73 \u0026plusmn; 0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.015 (S)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e9.4 \u0026plusmn; 5.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e6.73 \u0026plusmn; 0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.014 (S)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost-operative morbidities:\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e20 (29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e4 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e11(37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e4 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003eIncision infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e8 (12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e4 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003eLeakage\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e2 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e1 \u0026nbsp; \u0026nbsp; (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003ePost-operative ileus\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e5 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e2 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e3 \u0026nbsp; \u0026nbsp; (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e2 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003ePulmonological complications\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e1 \u0026nbsp; \u0026nbsp; (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003eDeath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e2 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e2 \u0026nbsp; \u0026nbsp; (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNS= Not significant\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study included 99 consecutive patients with adenocarcinoma of the colon and rectum operated on by laparoscopic or open technique during a period of nine months. According to the analyzed results, there was no statistically significant difference between these two groups in terms of age, gender, comorbidity, or disease stage. These results are expected, particularly following a period of mastering laparoscopic resection; the choice of surgical modality should therefore no longer be affected by any of the aforementioned parameters. The patients were more often men, older than 65 years, which is in line with the disease trends in the world [6]. According to GLOBOCAN (2020), the incidence of CRC is almost four times higher in developing countries than in developed countries, while the mortality rate does not vary greatly. Western Europe has one of the highest CRC rates, but considering socioeconomic development and lifestyle changes, an increase in the number of patients is expected in Southeast Europe. Screening programs have led to fewer advanced CRC cases in some countries, but this is offset by a concerning 1-4% annual rise in CRC incidence among those under 50, counteracting a positive trend observed among those aged 50 and over [6].\u003c/p\u003e\n\u003cp\u003eThere was no statistically significant difference between the groups in terms of cancer stages. The cancer stage was expected to influence the choice of surgical approach, as no patient undergoing laparoscopic surgery in the analyzed sample had a T4 stage. Laparoscopy is relatively contraindicated in T4 CRC resections as these tumors usually require multi-visceral resections, which are generally challenging using laparoscopy [7]. Pre- and post-matching comparisons of patho-histological variables (lymph node count, specimen length, resection margin) revealed no statistically significant difference in outcomes between laparoscopic and open surgeries. This confirms that in the center where the research was conducted, the laparoscopic technique in the treatment of CRC is completely equivalent to oncological open surgery. Similar results are published in a study by Dr. Kockerling where the resection margins of the preparations were analyzed, though he observed some variations in relation to the surgeon’s experience [8]. All the patients in this study were operated on by the same group of surgeons with over ten years of experience in colorectal surgery.\u003c/p\u003e\n\u003cp\u003eHospital stays and complication rates are significantly lower after laparoscopic surgery than after open surgery (p \u0026lt; 0.05). This is one key advantage of the laparoscopic technique. A shorter post-operative stay is the result of faster recovery and without the implementation of the accelerated recovery protocol, which was not applied regardless of the operative approach. The number of complications is five times higher in the open group. After matching, this difference is reduced to 2.75 times, which may indicate a conscious selection of high-risk patients for open surgery. Surgical site infection is the most common complication in open surgery, which is expected given the length of the surgical incision. These results are in line with a study published in BMC Surgery, which also compared the short-term and long-term outcomes of open surgery and laparoscopic surgery in patients with colorectal cancer.\u003c/p\u003e\n\u003cp\u003eAccording to the study, patients undergoing laparoscopic resection for CRC have a statistically significant shorter hospital stay and similar results to the open modality in terms of postoperative mortality and morbidity. Long-term survival, cancer-specific survival, and recurrence rates were similar in both cohorts [9]. Another study emphasized the feasibility of laparoscopy, especially for elderly patients with CRC. According to their results, laparoscopy has a shorter hospitalization and similar long-term results with an acceptable conversion rate that did not affect long-term results [10]. The shortcoming of our study is the absence of long-term follow-up of patients for a better comparison. However, an advantage of our study is having completed a propensity score optimal matching, after which identical results were obtained. Despite numerous studies indicating the advantages of laparoscopic surgery over traditional open surgery [2, 4, 11, 12], its implementation in the surgical treatment of colorectal cancer has been relatively slow. This stems from the laparoscopic technique’s intricate nature, requiring specialized skills and extensive experience [13].\u003c/p\u003e\n\u003cp\u003eLimitations of this study include a lack of long-term follow-up, a few patients, and non-randomized selection. Moreover, this study is retrospective, which, though valuable in some contexts, is often less reliable than prospective studies because it uses past data that may lead to inaccurate conclusions. Because these resections were for treating patients and were not pre-designed to be part of a research, researchers did not record the analyzed data consistently. Despite these drawbacks, retrospective studies have their place in science because they are quick, cheap, and easy to perform, and as such, are ideal for preliminary research [14].\u003c/p\u003e\n\u003cp\u003eFurthermore, different surgeons performed the interventions, leading to less consistent operation results and variability bias. Moreover, one key attribute any scientific research should have is replicability. If multiple surgeons performed, other researchers might find it difficult to replicate the study, which can call into question the validity of the results [15, 16]. On the other hand, all the surgeons who participated in this research are part of the same surgical team and follow identical standards of care in terms of preoperative surgery, oncological resection, and postoperative treatment and follow-up.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study confirms that laparoscopic and open surgery yield comparable short-term oncological results in colorectal cancer treatment; however, laparoscopic surgery provides better postoperative recovery. Patient’s overall health, surgeon’s expertise, disease progression, and available resources all play a role in deciding between laparoscopic and open surgical techniques. Optimal oncological resection, including dissecting adequate lymph nodes number and clear resection margin, was the primary surgical goal, irrespective of the technique used.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eNiš medical faculty ethical committee waived the need for consent or IRB. Data was anonymized data provided by the University for this retrospective study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Statement\u003c/strong\u003e - None\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Statement\u003c/strong\u003e - Human Ethics and Consent to Participate declarations - not applicable; a retrospective study, patients came for the sole purpose of treating their colorectal carcinoma and not to be part of this study. Data was collected during / after their surgeries for documentations purposes only\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest Statement\u003c/strong\u003e - none\u003c/p\u003e"},{"header":"References","content":"\u003col start=\"1\" type=\"1\"\u003e\n\u003cli\u003eBedirli A, Salman B, Yuksel O: Laparoscopic versus Open Surgery for Colorectal Cancer: A Retrospective Analysis of 163 Patients in a Single Institution. Minimally Invasive Surgery. 2014, 1-6. 10.1155/2014/530314\u003c/li\u003e\n\u003cli\u003eWorld Health Organization: WHO, World Health Organization: WHO. Colorectal cancer, Available from: https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer. https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer..\u003c/li\u003e\n\u003cli\u003eCurrais P, Rosa I, Claro I: Colorectal cancer carcinogenesis: From bench to bedside. World Journal of Gastrointestinal Oncology. 14. 10.4251/wjgo.v14.i3.654\u003c/li\u003e\n\u003cli\u003eMilone M, Manigrasso M, Burati M, et al.: Surgical resection for rectal cancer. Is laparoscopic surgery as successful as open approach? A systematic review with meta-analysis. PLoS ONE. 13. 10.1371/journal.pone.0204887\u003c/li\u003e\n\u003cli\u003eBonjer HJ, Deijen CL, Abis GA, et al.: A Randomized Trial of Laparoscopic versus Open Surgery for Rectal Cancer. New England Journal of Medicine. 372. 10.1056/NEJMoa1414882\u003c/li\u003e\n\u003cli\u003eSung H, Ferlay J, Siegel RL, et al.: Global Cancer Statistics. 2024. 10.3322/caac.21834\u003c/li\u003e\n\u003cli\u003eKlaver CEL, Kappen TM, Borstlap W a. A, et al.: Laparoscopic surgery for T4 colon cancer: a systematic review and meta-analysis. Surgical Endoscopy. 31. 10.1007/s00464-017-5544-7\u003c/li\u003e\n\u003cli\u003eKöckerling F, Reymond MA, Schneider C, et al.: Prospective multicenter study of the quality of oncologic resections in patients undergoing laparoscopic colorectal surgery for cancer. Diseases of the Colon \u0026amp; Rectum. 41. 10.1007/BF02237381\u003c/li\u003e\n\u003cli\u003eChern Y-J, Hung H-Y, You J-F, et al.: Advantage of laparoscopy surgery for elderly colorectal cancer patients without compromising oncologic outcome. BMC Surgery. 20. 10.1186/s12893-020-00967-6\u003c/li\u003e\n\u003cli\u003eZhou S, Wang X, Zhao C, et al.: Laparoscopic vs open colorectal cancer surgery in elderly patients: short- and long-term outcomes and predictors for overall and disease-free survival. BMC Surgery. 19. 10.1186/s12893-019-0596-3\u003c/li\u003e\n\u003cli\u003eBuunen M, Veldkamp R, Hop WCJ, et al.: Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. The. Lancet Oncology. 10. 10.1016/S1470-2045(08)70310-3\u003c/li\u003e\n\u003cli\u003eBeckmann K, Moore J, Wattchow D, et al.: Short‐term outcomes after surgical resection for colorectal cancer in South Australia. Journal of Evaluation in Clinical Practice. 23. 10.1111/jep.12612\u003c/li\u003e\n\u003cli\u003eKelly M, Bhangu A, Singh P, et al.: Systematic review and meta-analysis of trainee- versus expert surgeon-performed colorectal resection. British Journal of Surgery. 101. 10.1002/bjs.9472\u003c/li\u003e\n\u003cli\u003eBerndt AE: Sampling methods. Journal of Human Lactation. 36. 10.1177/0890334420906850\u003c/li\u003e\n\u003cli\u003eBobbitt Z. (Standardized vs. Unstandardized Regression Coefficients). Accessed: 09/11/2024: https://www.statology.org/standardized-vs-unstandardized-regression-coefficients/.\u003c/li\u003e\n\u003cli\u003eMenard S: Six approaches to calculating Standardized logistic regression coefficients. The American Statistician. 58. 10.1198/000313004X946\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Colorectal Adenocarcinoma, Laparoscopic Resections, Minimally Invasive Surgery, Open resections, Propensity Score, Laparotomy","lastPublishedDoi":"10.21203/rs.3.rs-6673998/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6673998/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cu\u003eIntroduction:\u003c/u\u003eSurgical resection of non-metastatic colorectal adenocarcinoma remains the gold standard treatment. Laparoscopy offers various advantages over the open surgical modality. However, the adoption of laparoscopy in different countries is slow because of the associated learning curve and the apprehension around the integrity of the resection margin.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eAim:\u003c/u\u003eTo compare short-term outcomes of laparoscopic and open resections for colorectal cancer performed in a single institution.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eMaterials and Methods:\u003c/u\u003e This study retrospectively analyzed the medical records of 99 consecutive patients who underwent elective resection for adenocarcinoma of the colon and rectum. Patients were divided into two groups, the open surgery group and the laparoscopic group, then matched into 30 pairs using a propensity score. Variables compared between the groups were demographics, tumor localization, type of resection, 30-day postoperative outcome, number of lymph nodes, length of resected specimens, distal margins, tumor T stage, and TNM stage.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eResults:\u003c/u\u003eCompared to open surgery, laparoscopy resulted in significantly shorter hospital stays and reduced complications, particularly infections (p \u0026lt; 0.05), in the matched patients. There was no statistical difference between the groups in the other analyzed variables (p \u0026gt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eConclusion:\u003c/u\u003eThe results suggest that patients who underwent laparoscopic resection experienced significant improvements in the first 30 days postoperatively when compared to patients who underwent open resection. Patients in the laparoscopy group had fewer complications, a faster postoperative recovery, and a shorter hospital stay than patients in the open group, while adhering to oncological resection principles.\u003c/p\u003e","manuscriptTitle":"Comparing the Outcomes of Laparoscopic and Open Resections of Colorectal Cancer","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-23 15:36:51","doi":"10.21203/rs.3.rs-6673998/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"11f2ce76-3ab7-423b-b01a-905d19f3c54a","owner":[],"postedDate":"September 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-23T15:36:51+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-23 15:36:51","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6673998","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6673998","identity":"rs-6673998","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}