Table 3.
Surgical quality indicators for 612 patients.
| Quality Indicators | <18.5 Underweight n = 7) | 18.5–25 Normal Weight (n = 212) | 25–30 Overweight (n = 266) | 30–35 Obese Class I (n = 102) | 35–40 Obese Class II (n = 16) | ≥40 Obese Class III (n = 9) | p | Group 1: 18.5–35 (n = 580) | Group 2: <18.5 & ≥ 35 (n = 32) | p |
|---|---|---|---|---|---|---|---|---|---|---|
| Number of examined LN; R0, R1, R2 n = 612 a, median (range) | 13 (11–33) | 20 (2–57) | 21.5 (3–62) | 21 (5–76) | 23.5 (8–57) | 30 (15–43) | 21 (2–76) | 25.5 (8 – 57) | ||
| ≥ 12 LN examined | 6/7 (86) | 188/212 (88.7) | 239/266 (89.8) | 93/102 (91.2) | 15/16 (94) | 9/9 (100) | 0.828 | 520/580 (89.7) | 30/32 (94) | 0.742 |
| pN0 n = 217, median (range) | 33 (33–33) | 24 (12–51) | 27 (7–57) | 31 (10–76) | 30 (22–36) | 26 (15–41) | 26 (7–76) | 30 (15–41) | ||
| ≥ 12 LN examined | 1/1 (100) | 67/67 (100) | 98/100 (98.0) | 41/42 (97.6) | 4/4 (100) | 3/3 (100) | 0.664 | 206/209 (98.6) | 8/8 (100) | 0.737 |
| ypN0 n = 235, median (range) | 13 (12–13) | 17 (2–36) | 18 (3–62) | 17 (7–37) | 21 (8–29) | 41 (16–43) | 17.5 (2–62) | 16 (8–43) | ||
| ≥ 12 LN examined | 3/3 (100) | 70/90 (77.8) | 79/102 (77.5) | 26/30 (86.7) | 6/7 (86) | 3/3 (100) | 0.004 | 175/222 (78.8) | 12/13 (92) | 0.238 |
| R0—resection-rate | 5/7 (71) | 209/212 (98.6) | 257/266 (96.6) | 102/102 (100) | 16/16 (100) | 9/9 (100) | 0.031 | 568/580 (97.9) | 30/32 (94) | 0.163 |
| Aboral resection margin > 1 mm | 7/7 (100) | 210/212 (99.1) | 263/266 (98.9) | 100/102 (98.0) | 15/16 (94) | 9/9 (100) | 0.474 | 573/580 (98.8) | 31/32 (97) | 0.351 |
| Circumferential resection margin > 1 mm | 5/7 (71) | 197/212 (92.9) | 244/266 (91.7) | 98/102 (96.1) | 15/16 (94) | 9/9 (100) | 0.186 | 539/580 (92.9) | 29/32 (91) | 0.096 |
| Intraoperative local tumour cell dissemination | 2/7 (29) | 10/212 (4.7) | 14/266 (5.3) | 2/102 (2.0) | 1/ 16 (6) | 0/9 (0) | 0.112 | 26/580 (4.5) | 3/32 (9) | 0.279 |
| Quality of TME/PME b | ||||||||||
| Mesorectal/intramesorectal plane | 6/6 (100) | 190/196 (96.9) | 246/253 (97.2) | 91/92 (98.9) | 14/15 (93,3) | 8/9 (88,9) | 527/541 (97.4) | 28/30 (93) | ||
| Muscularis propria plane | 0/6 (0) | 6/196 (3.1) | 7/253 (2.8) | 1/92 (1.1) | 1/15 (6,7)) | 1/9 (11,1) | 0.309 | 14/541 (2.6) | 2/30 (7) | 0.203 |
| Abdominoperineal excision | ||||||||||
| All locations | 4/7 (57) | 36/212 (17.0) | 39/266 (14.7) | 14/102 (13.7) | 4/16 (25) | 2/9 (23) | 0.074 | 89/580 (15.3) | 10/32 (31) | 0.025 |
| <6 cm lower third | 4/4 (100) | 30/83 (36.1) | 30/82 (36.6) | 14/34 (41.2) | 4/5 (80) | 2/3 (67) | <0.001 | 74/199 (37.2) | 10/12 (83) | <0.001 |
| 6–12 cm middle third | 0/3 (0) | 6/84 (7.1) | 9/132 (6.8) | 0/43 (0) | 0/9 (0) | 0/5 (0) | <0.001 | 15/259 (5.8) | 0/17 (0) | <0.001 |
| Anastomosis | 2/7 (29) | 173/212 (81.6) | 224/266 (84.2) | 87/102 (85.3) | 12 /16 (75) | 7/9 (78) | 0.019 | 484/580 (83.4) | 21/32 (66) | 0.016 |
| Anastomotic leak | 0/2 (0) | 5/173 (2.9) | 10/224 (4.5) | 7/87 (8) | 0/12 (0) | 0/7 (0) | 0.466 | 22/484 (4.5) | 0/21 (0) | 1.0 |
| Morbidity | ||||||||||
| Total | 2/7 (29) | 39/212 (18.4) | 55/266 (20.7) | 29/102 (28.4) | 9/16 (56) | 3/9 (33) | 0.008 | 123/580 (21.2) | 14/32 (44) | 0.005 |
| Non-surgical | 0/7 (0,) | 9/212 (4.2) | 12/266 (4.5) | 7/102 (6.8) | 1/16 (6) | 0/9 (0) | 0.460 | 26/580 (4.5) | 1/32 (3) | 1.0 |
| Surgical | 2/7 (29) | 30/212 (14.1) | 43/266 (16.2) | 22/102 (21.6) | 8/16 (50) | 3/9 (33) | 0.006 | 95/580 (16.4) | 13/32 (41) | 0.001 |
| Postoperative 30-day mortality | 1/7 (14) | 3/212 (1.4) | 1/266 (0.4) | 1/102 (1.0) | 0/16 (0) | 0/9 (0) | 0.116 | 5/580 (0.9) | 1/32 (3) | 0.282 |
a R0 = 598 patients + R1 = 9 patients + R2 = 5 patients = 612 patients; b 41 patients missing due to unknown data.