Impact of Conversion from Laparoscopy to Open Surgery in Patients with Right Colon Cancer

Abstract

Conversion to open surgery is reported in up to 20 per cent of laparoscopic colectomies for cancer. This study aims to compare postoperative outcomes and survival between converted and successful laparoscopic right colectomy for cancer. Records of patients who underwent laparoscopic right colectomy for cancer between 2005 and 2015 were retrieved from the CLermontFerrand Ircad Mondor Hopital European Tours (CLIMHET) database. Perioperative, postoperative, and survival outcomes were evaluated. Multivariate analysis was performed to identify predictive factors for conversion. Overall, 445 patients underwent a successfully completed laparoscopic right colectomy and 28 (5.9%) were converted to open surgery. A higher rate of minor complications was found in the conversion group, whereas patient recovery outcomes were similar. Previous open and laparoscopic surgeries were significant predictors of conversion. No significant difference was found in overall and disease-free survival rates between converted and nonconverted procedures. In the setting of laparoscopic right colectomy for cancer, the conversion rate is low and does not have an impact on patient survival. Conversion is associated with higher rates of minor postoperative complications but recovery and survival outcomes are comparable with successful laparoscopic colectomies. The present results support the use of laparoscopy for right colon resection even in patients at risk of conversion.

Effect of Ultrasound-Guided Quadratus Lumborum Block Preemptive Analgesia on Postoperative Recovery of Patients with Open Radical Colon Cancer Surgery: A Retrospective Study

“…However, laparoscopic surgery could not completely substitute open surgery in several circumstances, including vast tumor invasions and emergency operations. 1,[19][20][21][22][23] In fact, due to various reasons, surgeons mainly perform open surgery in our hospital. However, due to the factors such as surgical injury, organ stretch ischemia, inflammatory exudate stimulation in abdominal cavity and large incision in the abdominal wall, patients can feel moderate-to-severe pain after surgery.…”

Risk factors and surgical outcomes of conversion of minimally invasive surgery to open procedure

“…Petrucciani et al reported significantly higher rates of minor postoperative complications (Clavien-Dindo grade I and II complications) in patients who underwent conversion for laparoscopic right colectomy compared to the laparoscopic group. [10][11][12][13] In our study, total 90.24% patients Clavien-Dindo grade I and II complications.…”

Impact of operation duration on postoperative outcomes of minimally‐invasive right colectomy

“…Over the entire MERCY study group sample of 1870 patients, 104 (5.6%) patients were excluded due to missing operating time. Additionally, 139 (7.4%) patients were excluded because a conversion to open surgery was required (defined as an enlargement of the abdominal incision more than that required for specimen extraction [3, 35]) and 78 (4.2%) because they required multivisceral resections. Thus, the analytic sample was composed of 1549 patients (Figure 1).…”

“…abdominal incision more than that required for specimen extraction [3,35]) and 78 (4.2%) because they required multivisceral resections. Thus, the analytic sample was composed of 1549 patients (Figure 1).…”