Aims Laparoscopic CRC resection has evolved as main surgery in colorectal malignancies (66 % NBOCA report 2022). Lap-open conversion reported in < 21 % cases. Aim of study is to assess causes of lap-open conversions at a single centre. Methods Cohort study carried out from Jan'2008 to Jan'2023; evaluations of demographics & postoperative outcomes in lap-open CRC resections. Laparoscopic and open colorectal CRC resections were recruited as controls Result Lap-open (n = 121) Laparoscopic (n = 839) Open (n = 751) Kruskal-Wallis test (p value) Age(yrs) 69.2 70.0 71.0 NS Sex(M:F) 86 : 35 454 : 385 415 : 336 < 0.005 ASA(median) 2 2 2 NS BMI(kg/m2) 27.6 26.3 26.6 < 0.01 Operation time(mins) 235.1 191.4 146.5 < 0.0001 Elective(CRC(n) 113 774 462 < 0.0001 Emergency CRC(n) 8 65 289 < 0.0001 Complications(n) Leaks 4 27 35 NS Ileus 16 124 134 NS HAP 17 74 94 < 0.05 Anaemia(Tx) 7 60 28 < 0.05 Wound infections 21 60 74 < 0.001 Collections 8 39 49 NS Sepsis 8 34 44 NS LN harvest(median) 17 18 16 < 0.001 LOS(days) 8 6 10 < 0.0001 Mortality(n) 30 days 1 22 35 < 0.05 60 days 2 34 48 < 0.05 90 days 2 39 57 < 0.001 Survival rates 1styear 94.1 90.8 83.5 5thyear 81.2 7.2 63.1 Logrank 10thyear 77.2 70.0 54.1 p < 0.005 15thyear 77.2 68.9 50.0 Conclusion Lap-open conversion rate was 12.6 %. Lap-open conversion resulted in prolonged operation and hospitalization, survival was unaffected. Causes of lap-open conversions characterized into pre-operative cause (high BMI, multiple operations, comorbidities), intra-operative causes (access, adhesions, fatty mesentery, tumour factors, anatomical difficulties, equipment failure).
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Gok et al. (2024) studied this question.
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