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Page 6 of 12                                   Funahashi et al. Mini-invasive Surg 2018;2:27  I  http://dx.doi.org/10.20517/2574-1225.2018.28


               Table 1. Patient characteristics of the APR and SPR groups
                                                        SPR (n = 73)         APR (n = 17)       P value
                Gender (%)                                                                      0.256
                  Male                                  49 (67.1)             14 (82.4)
                  Female                                24 (32.9)             3 (17.6)
                Age, years (range)                      61 (33-79)            69 (40-80)        0.013
                      2
                BMI, kg/m  (range)                      23.3 (16.7-32.9)      21.6 (17.5-32.8)  0.160
                Pre-CRT (%)                             14 (19.2)             1 (5.9)           0.286
                Operation type                                                                  0.040
                  Open                                  33 (45.2)             13 (76.5)
                  Laparoscopic                          40 (54.8)             4 (23.5)
                Quality of TME (%)                                                              1.000
                  Complete                              69 (94.5)             17 (100)
                  Near complete                         1 (1.4)               0
                  NE                                    3                     0
                Circumferential resection margin (%)                                            1.000
                  Negative                              68 (93.1)             17 (100)
                  Positive                              2 (2.7)               0
                  NE                                    3                     0
                Maximum tumor size in specimen, mm (range)  34.5 (8-109)
                Pathological TNM staging                                                        0.243
                  I                                     27 (37.0)             3 (17.6)
                  II                                    23 (31.5)             9 (52.9)
                  III                                   22 (30.1)             4 (23.5)
                  NE                                    1 (1.4)               1 (6.0)
               Data shown as median (range) or n (%). BMI: body mass index; Pre-CRT: preoperative chemoradiation therapy; TME: total mesorectal
               excision; TNM: tumor-node-metastasis; SPR: sphincter-preserving resection; APR: abdominoperineal resection; NE: not evaluated

               Table 2. Recurrence after surgery
                                                        SPR (n = 73)         APR (n = 17)       P value
                Recurrence (%)                          13 (17.8)              5 (29.1)          0.317
                  Local                                 5 (6.8)                0                 0.248
                  Distant                               8 (11.0)               5 (29.1)
                     Liver                              2                      2
                     Lung                               5                      1
                    Other                               1                      2
                Median follow-up period, days (range)   3958 (2778-6583)
               Data shown as n (%).SPR: sphincter-preserving resection; APR: abdominoperineal resection


               differences in either were observed between the 2 groups (P = 0.751 and P = 0.892, respectively). The 5-year
               overall survival rate in the patients who underwent SPR was 100% for those with stage I disease, 86.5% for
               stage II disease, and 72.1% for stage III disease [Figure 2].

               Functional results
               During a median follow-up period of 1450 days (range 475-2544 days), 11 patients did not respond to the
               questionnaire. Surveys were stopped in 4 patients because of cancer recurrence. Two patients did not con-
               sent to an ileostomal closure. One patient required a permanent colostomy because of a perineal hernia
               after a pelvic-bone fracture. Ultimately, anal function was assessed in 55 of the 73 SPR patients (75.3%): 18
               conventional CAA patients, 22 partial ISR patients, and 15 massive ISR patients [Table 4]. The functional
               outcomes of the 3 groups are shown in Table 5.


               A significant difference in the WI score (P = 0.005), LARS score (P = 0.002), and VAS score (P = 0.047) was
               observed between the 3 groups.
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