Impact of conversion on short and long-term outcome in laparoscopic resection of curable colorectal cancer

JSLS. Apr-Jun 2011;15(2):182-7. doi: 10.4293/108680811X13071180406439.

Abstract

Introduction: Long-term outcome of patients following conversion during laparoscopic surgery for colorectal cancer is not often reported. Recent data suggest a negative impact of conversion on long-term survival. This study aimed to evaluate the impact of conversion on the perioperative outcome and on long-term survival in patients who underwent laparoscopic resection for curable colorectal cancer.

Methods: Evaluation of our prospective in-hospital collected data of patients who underwent laparoscopic surgery for curable colorectal cancer over a 5-year period. Long-term data were collected from our outpatient's clinic data and personal contact when necessary.

Results: During the study period, 175 patients were operated on laparoscopically for curable colon cancer (stage I-III). Mean follow-up was 33±18 months with a minimum follow-up of 12 months. For various reasons, 25 patients (14.4%) had to be converted to open surgery. Short-term outcome revealed a trend towards longer operations, a higher rate of surgical complications, and a longer hospital stay in the converted group. Five-year, Kaplan-Meier, disease-free analysis was worse for converted patients. Overall survival did not differ between the 2 groups. Cox proportional hazards regression analysis revealed that conversion and AJCC stage were independent risk factors for recurrence.

Conclusions: Conversion in laparoscopic surgery for curable colorectal cancer is associated with a worse perioperative outcome and worse disease-free survival.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Colonic Neoplasms / mortality
  • Colonic Neoplasms / surgery*
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Laparoscopy*
  • Male
  • Prognosis
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / surgery*
  • Surgical Wound Infection / epidemiology
  • Treatment Failure
  • Treatment Outcome