Table 1. Comparative findings of studies of laparoscopic versus open TME.
| COLOR II 14 | ACOSOG 17 | AlaCaRT 18 | ||||
|---|---|---|---|---|---|---|
| Study period | January 2004 to May 2010 | October 2008 to September 2013 | March 2010 to November 2014 | |||
| Study location | Europe | United States | Australia/New Zealand | |||
| Total number of patients | 1103 | 486 | 475 | |||
| Laparoscopic | Open | Laparoscopic | Open | Laparoscopic | Open | |
| Patient and tumor characteristics, n | 699 | 345 | 242 | 239 | 238 | 235 |
| Male gender, n (%) | 448 (64) | 211 (61) | 156 (65) | 158 (66) | 160 (67) | 151 (64) |
| Age, mean ± SD, y | 66.8 ± 10.5 | 65.8 ± 10.9 | 57.7 ± 11.5 | 57.2 ± 12.1 | 65 (56–74) a | 65 (56–73) a |
| Body mass index, mean ± SD, kg/m 2 | 26.1 ± 4.5 | 26.5 ± 4.7 | 26.4 ± 4.0 | 26.8 ± 4.2 | 27 (24–30) a | 26 (24–30) a |
| Tumor location, n (%) | ||||||
| Lower rectum (< 5 cm from AV) | 203 (29) | 93 (27) | 124 (51) | 116 (49) | 82 (35) | 83 (35) |
| Middle rectum (5–10 cm from AV) | 273 (39) | 136 (39) | 85 (35) | 95 (40) | 103 (43) | 102 (44) |
| Upper rectum (10–15 cm from AV) | 223 (32) | 116 (34) | 33 (14) | 28 (12) | 53 (22) | 50 (21) |
| Preoperative stage, n (%) | ||||||
| I | 201 (29) | 96 (28) | 2 (1) | 3 (1) | – | – |
| II | 209 (30) | 107 (31) | 99 (41) | 92 (39) | ||
| III | 257 (37) | 126 (37) | 141 (58) | 144 (60) | ||
| Preoperative radiotherapy, n (%) | 412 (59) | 199 (58) | 235 (97) | 230 (96) | 119 (50) | 116 (49) |
| Preoperative chemotherapy | 196 (28) | 99 (29) | 231 (95) | 225 (94) | ||
| Clinical outcomes, n | 699 | 345 | 240 | 222 | ||
| Total operative time, mean ± SD, min | 200 (100–400) a | 400 (200–700) a | 266.2 ± 101.9 | 220.6 ± 92.4 | 210 (163–253) a | 190 (160–240) a |
| Conversions, n (%) | 121 (17) | – | 26 (11) | – | 21 (9) | – |
| Overall morbidity at 28 d, n (%) | 278 (40) | 128 (37) | 137 (57) | 129 (58) | – | – |
| Overall mortality at 28 d, n (%) | 8 (1) | 6 (2) | 2 (1) | 2 (1) | 1 (< 1) | 2 (1) |
| Anastomotic leak, % | 58 (8) | 25 (7) | 5 (2) | 5 (2) | 7 (3) | 8 (3) |
| Unplanned reoperation, % | 113 (16) b | 52 (15) b | 12 (5) | 5 (2) | – | – |
| Length of hospital stay, median (IQR), d | 8 (6–13) a | 9 (7–14) a | 7.3 ± 5.4 | 7.0 ± 3.4 | 8 (6–12) a | 8 (6–12) a |
| Pathological outcomes, n | 699 | 345 | 240 | 222 | ||
| Positive CRM, n (%) | 56 (8) | 30 (9) | 29 (12) | 17 (8) | 16 (7) | 7 (3) |
| Positive DRM, n (%) | – | – | 6 (3) | 4 (2) | 2 (1) | 1 (1) |
| TME quality, n (%) | ||||||
| Complete | 589 (84) | 303 (88) | 175 (73) | 181 (82) | 206 (87) | 216 (92) |
| Nearly/partially complete | 58 (8) | 19 (6) | 46 (19) | 30 (14) | 24 (10) | 17 (7) |
| Incomplete | 19 (3) | 9(3) | 19 (8) | 11 (5) | 8 (3) | 2 (1) |
| Number of lymph nodes, mean ± SD | 13 (10–18) a | 14 (10–19) a | 17.9 ± 10.1 | 16.5 ± 8.4 | – | – |
Abbreviations: AV, anal verge; CRM, circumferential resection margin; DRM, distal resection margin; IQR, interquartile range; SD, standard deviation; TME, total mesorectal excision.
a
Reported as median and interquartile range (IQR).
b
Reported reintervention.