PURPOSE: Laparoscopic colon resection is technically challenging, and conversion to open surgery is sometimes unavoidable. The impact of conversion may vary among different types of colorectal resection and pathology. Our present study aims at evaluating the risk factors and clinical outcomes of conversion in laparoscopic resection for right colon cancer. METHODS: Between the periods April 1992 to July 2007, 183 consecutive patients undergoing laparoscopic-assisted right colon resection for carcinoma of colon were identified from our database. Data pertaining demographic information, operative details, postoperative course, complications, length of stay, 30-day mortality, and follow-up status were analyzed. RESULTS: The overall conversion rate was 12% (22 patients). Stage IV disease, tumor length >5 cm, and surgery performed in an earlier time period (before year 2002) were independent risk factors for conversion. Although the median operative time was comparable (195 vs 180 min, p = 0.074), more blood loss was recorded among the conversion group (350 vs 20 ml, p < 0.001). Conversion was also associated with higher wound infection rate (27.3% vs 5%, p = 0.002) and 30-day mortality (9.1% vs 0.62%, p = 0.039). After potential curative resection, the 5-year overall survival rate of the conversion and no conversion group was 53.8% and 72.6%, respectively (p = 0.039). CONCLUSIONS: Our results showed that conversion increased the intraoperative blood loss, wound related morbidities, and the 30-day mortality. Moreover, it had negative impact on overall survival.
PURPOSE: Laparoscopic colon resection is technically challenging, and conversion to open surgery is sometimes unavoidable. The impact of conversion may vary among different types of colorectal resection and pathology. Our present study aims at evaluating the risk factors and clinical outcomes of conversion in laparoscopic resection for right colon cancer. METHODS: Between the periods April 1992 to July 2007, 183 consecutive patients undergoing laparoscopic-assisted right colon resection for carcinoma of colon were identified from our database. Data pertaining demographic information, operative details, postoperative course, complications, length of stay, 30-day mortality, and follow-up status were analyzed. RESULTS: The overall conversion rate was 12% (22 patients). Stage IV disease, tumor length >5 cm, and surgery performed in an earlier time period (before year 2002) were independent risk factors for conversion. Although the median operative time was comparable (195 vs 180 min, p = 0.074), more blood loss was recorded among the conversion group (350 vs 20 ml, p < 0.001). Conversion was also associated with higher wound infection rate (27.3% vs 5%, p = 0.002) and 30-day mortality (9.1% vs 0.62%, p = 0.039). After potential curative resection, the 5-year overall survival rate of the conversion and no conversion group was 53.8% and 72.6%, respectively (p = 0.039). CONCLUSIONS: Our results showed that conversion increased the intraoperative blood loss, wound related morbidities, and the 30-day mortality. Moreover, it had negative impact on overall survival.
Authors: Jimmy C M Li; Sophie S F Hon; Simon S M Ng; Janet F Y Lee; Raymond Y C Yiu; Ka Lau Leung Journal: Surg Endosc Date: 2009-05-19 Impact factor: 4.584
Authors: Ruben Veldkamp; Esther Kuhry; Wim C J Hop; J Jeekel; G Kazemier; H Jaap Bonjer; Eva Haglind; Lars Påhlman; Miguel A Cuesta; Simon Msika; Mario Morino; Antonio M Lacy Journal: Lancet Oncol Date: 2005-07 Impact factor: 41.316
Authors: Pierre J Guillou; Philip Quirke; Helen Thorpe; Joanne Walker; David G Jayne; Adrian M H Smith; Richard M Heath; Julia M Brown Journal: Lancet Date: 2005 May 14-20 Impact factor: 79.321
Authors: Ka Lau Leung; Samuel P Y Kwok; Steve C W Lam; Janet F Y Lee; Raymond Y C Yiu; Simon S M Ng; Paul B S Lai; Wan Yee Lau Journal: Lancet Date: 2004-04-10 Impact factor: 79.321
Authors: James Fleshman; Daniel J Sargent; Erin Green; Mehran Anvari; Steven J Stryker; Robert W Beart; Michael Hellinger; Richard Flanagan; Walter Peters; Heidi Nelson Journal: Ann Surg Date: 2007-10 Impact factor: 12.969
Authors: N A Rotholtz; M Laporte; G Zanoni; M E Bun; L Aued; S Lencinas; N A Mezzadri; L Pereyra Journal: Tech Coloproctol Date: 2008-05-30 Impact factor: 3.781
Authors: Michael S Tam; Christodoulos Kaoutzanis; Andrew J Mullard; Scott E Regenbogen; Michael G Franz; Samantha Hendren; Greta Krapohl; James F Vandewarker; Richard M Lampman; Robert K Cleary Journal: Surg Endosc Date: 2015-04-17 Impact factor: 4.584
Authors: Jimmy Chak-Man Li; Ka Lau Leung; Simon Siu-Man Ng; Shirley Yuk-Wa Liu; Janet Fung-Yee Lee; Sophie Sok-Fei Hon Journal: Int J Colorectal Dis Date: 2011-08-23 Impact factor: 2.571
Authors: Marco E Allaix; Giuseppe Giraudo; Massimiliano Mistrangelo; Alberto Arezzo; Mario Morino Journal: Surg Endosc Date: 2014-08-09 Impact factor: 4.584