Laparoscopic conversion to open in rectal cancer resection: effect on short-term and oncological outcomes

Abdelgawaad Shalkamy, Moamen S.; Ahmed, Gamal A.; Elkhateeb, Abdelmoniem I.; Shehata, Mahmoud R.; Hanna, Ragai S.; Mohammed Abouelhassan, Ahmed S.

doi:10.4103/1115-2613.278267

Laparoscopic conversion to open in rectal cancer resection: effect on short-term and oncological outcomes

Authors

Abstract

Background
Laparoscopy has been accepted to be safe and feasible in rectal cancer resection. The effect of conversion to open on short-term and long-term oncological outcomes in colorectal patients with cancer is still unclear. The aim of this study was to evaluate the short-term and oncological outcomes of conversion in patients undergoing laparoscopic resection for rectal cancer.
Patients and methods
The data of 40 patients who underwent laparoscopic rectal cancer resection were prospectively collected. Of the 40 patients, eight (20%) patients underwent conversion to open surgery. Laparoscopic-successful group and laparoscopic-conversion group patients were compared.
Results
Locally advanced tumor was the commonest reason for conversion (37.5%). Laparoscopic-conversion group had more intraoperative complications (=0.017), greater blood loss (=0.051), longer operative time (=0.001), and lower rate of total mesorectal excision completeness (=0.046) compared with laparoscopic-successful group. Pathological T4 was significantly higher in laparoscopic-converted group than in laparoscopic-successful group. The rate of local recurrence (50 vs. 10.3%) was significantly higher in laparoscopic-conversion group than in laparoscopic-successful group (=0.027). Two-year disease-free survival was significantly prolonged in laparoscopic-successful group than in laparoscopic-conversion group (=0.033).
Conclusion
Conversion to open surgery in laparoscopic rectal resection has a negative effect on intraoperative outcomes and could be a negative predictive factor for long-term oncological outcomes.

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