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Title of Journal: Surg Endosc

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Abbravation: Surgical Endoscopy

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Springer US

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DOI

10.1006/jcis.1999.6110

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ISSN

1432-2218

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Conversions in laparoscopic surgery for rectal can

Authors: Martijn H G M van der Pas Charlotte L Deijen Gabor S A Abis Elly S M de Langede Klerk Eva Haglind Alois Fürst Antonio M Lacy Miguel A Cuesta Hendrik J Bonjer For the COLOR II study group
Publish Date: 2016/10/20
Volume: 31, Issue: 5, Pages: 2263-2270
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Abstract

Laparoscopic surgery offers patients with rectal cancer shortterm benefits and similar survival rates as open surgery However selecting patients who are suitable candidates for laparoscopic surgery is essential to prevent intraoperative conversion from laparoscopic to open surgery Clinical and pathological variables were studied among patients who had converted laparoscopic surgeries within the COLOR II trial to improve patient selection for laparoscopic rectal cancer surgeryBetween January 20 2004 and May 4 2010 1044 patients with rectal cancer enrolled in the COLOR II trial and were randomized to either laparoscopic or open surgery Of 693 patients who had laparoscopic surgery 114 16  were converted to open surgery Predictive factors were studied using multivariate analyses and morbidity and mortality rates were determinedFactors correlating with conversion were as follows age above 65 years OR 19 95  CI 12–30 p = 0003 BMI greater than 25 OR 27 95  CI 17–43 p  0001 and tumor location more than 5 cm from the anal verge OR 05 CI 03–09 Gender was not significantly related to conversion p = 014 In the converted group blood loss was greater p  0001 and operating time was longer p = 0028 compared with the nonconverted laparoscopies Hospital stay did not differ p = 006 Converted procedures were followed by more postoperative complications compared with laparoscopic or open surgery p = 0041 and p = 0042 respectively Mortality was similar in the laparoscopic and converted groupsAndré d’Hoore Universitair Ziekenhuis Leuven Belgium Dan Birch Chris DeGara Royal Alexandra Hospital Canada Chris Jamieson Dalhousie University Canada Poornoroozy Peiman Karl Juul Jensen SVS Esbjerg Denmark Orhan Bulut Per Jess Hillerod Hospital Denmark Jacob Rosenberg Herlev Hospital Denmark Thomas Harvald Gentofte Amtssygehus Denmark Henrik Ovesen Roskilde Sygehus Denmark Eskilde Lundhus Regionshospitalet Viborg Denmark Igors Iesalnieks Ayman Agha University Hospital Regensburg Germany Christina Jaeger Marienhospital Germany Martin Kreis Michael Kasparek Ludwig Maximillians Universtitat klinikum Groβhadern Germany Alois Fürst Gudrun LiebigHoerl Caritas Krankenhaus St Josef Regensburg Germany Seon Hahn Kim Korea University Anam Hospital Korea Jaap Bonjer Donald van der Peet Miguel Cuesta Martijn van der Pas Mark Buunen Gabor Abis Charlotte Deijen Elly de Langede Klerk VU University Medical Center The Netherlands Wim Hop Erasmus Medical Center The Netherlands Peter Neijenhuis Rijnland Ziekenhuis The Netherlands Peter Paul Coene Edwin van der Harst Maasstad Ziekenhuis The Netherlands Yvonne van ‘t Riet Catharina Ziekenhuis Eindhoven The Netherlands Willem Bemelman Academisch Medisch Centrum The Netherlands Michael Gerhards Onze Lieve Vrouwe Gasthuis The Netherlands Hubert Prins Jeroen Bosch Ziekenhuis Hertogenbosch The Netherlands Eduardo Targarona Carmen Balague Carmen Martinez Hospital de Sant Pau Spain Juan Franco Osorio Garcia Molina Hospital SAS de Jerez Spain Antonio Lacy Salvadora Delgado Hospital clinic I Provincial de Barcelona Spain Juan Lujan Graciela Valero Arrixaca Hospital Universitario Spain Alfredo AlonsoPoza Manual Losadar Salvador Argudo Hospital del Sureste de Madrid Spain Zoltan Lackberg Uddevalla Hospital Sweden Stefan Skullman KarnsjukhusetSkovde Hospital Sweden Goran Kurlberg Eva Haglind John Andersson Eva Angenete Jan Ekelund Sahlgrenska Universitetssjukhuset Goteborg Sweden Ulf Kressner Danderyd Hospital Sweden Peter Matthiessen Orebro University Sweden“André d’Hoore Dan Birch Chris DeGara Chris Jamieson Poornoroozy Peiman Karl Juul Jensen Orhan Bulut Per Jess Jacob Rosenberg Thomas Harvald Henrik Ovesen Igors Iesalnieks Ayman Agha Christina Jaeger Martin Kreis Michael Kasparek Alois Fürst Gudrun LiebigHoerl Seon Hahn Kim Jaap Bonjer Donald van der Peet Miguel Cuesta Martijn van der Pas Mark Buunen Gabor Abis Charlotte Deijen Elly de Langede Klerk Wim Hop Peter Neijenhuis Peter Paul Coene Edwin van der Harst Yvonne van ‘t Riet Willem Bemelman Michael Gerhards Hubert Prins Eduardo Targarona Carmen Balague Carmen Martinez Juan Franco Osorio Garcia Molina Antonio Lacy Salvadora Delgado Juan Lujan Graciela Valero Alfredo AlonsoPoza Manual Losadar Salvador Argudo Zoltan Lackberg Stefan Skullman Goran Kurlberg Eva Haglind John Andersson Eva Angenete Jan Ekelund Ulf Kressner and Peter Matthiessen have no conflicts of interest or financial ties to disclose”

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