Impact of conversion on outcome in laparoscopic colorectal cancer surgery

Wideochir Inne Tech Maloinwazyjne. 2012 Jun;7(2):74-81. doi: 10.5114/wiitm.2011.25799. Epub 2011 Nov 22.

Abstract

Introduction: Long-term results after laparoscopic surgery with conversion to open surgery for colorectal cancer are seldom published.

Aim: The study analysed the impact of conversion of laparoscopic surgery to open resection for colorectal cancer on short- and long-term results.

Material and methods: The prospectively collected data of 469 patients with colorectal cancer in the period from 1 January 2001 to 31 December 2006 were analysed. Short- and long-term results were compared.

Results: The relative frequency of conversion was 7%. The subgroups were statistically similar regarding age, gender, body mass index (BMI), localization of tumour, T stage, and TNM stage. We observed a lower frequency of previous surgery (p = 0.018) in the group of patients with conversions to open surgery as well as statistically significantly higher frequency of patients with American Society of Anesthesiologists (ASA) score II (p = 0.039). There was no statistical difference in morbidity, mortality, or the length of hospital stay between both the groups of patients. The operating time was significantly higher in the group of patients with conversion (p = 0.00001). There was a significantly higher blood loss in the patient groups with conversion to open surgery and in the group with primarily open surgery (p = 0.00023). There was no difference in the overall survival (p = 0.712), disease-free survival (p = 0.072) or in the local (p = 0.432) or distant (p = 0.957) recurrence.

Conclusions: No negative impact on short- or long-term results of conversion to open surgery was verified in patients with colorectal surgery.

Keywords: colorectal cancer; colorectal surgery; conversion; laparoscopic resection; survival.