Conversions in laparoscopic surgery for rectal cancer

For the COLOR II study group

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Laparoscopic surgery offers patients with rectal cancer short-term benefits and similar survival rates as open surgery. However, selecting patients who are suitable candidates for laparoscopic surgery is essential to prevent intra-operative 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 surgery. Methods: Between 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 determined. Results: Factors correlating with conversion were as follows: age above 65 years (OR 1.9; 95 % CI 1.2–3.0: p = 0.003), BMI greater than 25 (OR 2.7; 95 % CI 1.7–4.3: p < 0.001), and tumor location more than 5 cm from the anal verge (OR 0.5; CI 0.3–0.9). Gender was not significantly related to conversion (p = 0.14). In the converted group, blood loss was greater (p < 0.001) and operating time was longer (p = 0.028) compared with the non-converted laparoscopies. Hospital stay did not differ (p = 0.06). Converted procedures were followed by more postoperative complications compared with laparoscopic or open surgery (p = 0.041 and p = 0.042, respectively). Mortality was similar in the laparoscopic and converted groups. Conclusions: Age above 65 years, BMI greater than 25, and tumor location between 5 and 15 cm from the anal verge were risk factors for conversion of laparoscopic to open surgery in patients with rectal cancer.

Original languageEnglish
Pages (from-to)2263-2270
Number of pages8
JournalSurgical Endoscopy and Other Interventional Techniques
Volume31
Issue number5
DOIs
Publication statusPublished - 2017 May 1
Externally publishedYes

Fingerprint

Rectal Neoplasms
Laparoscopy
Conversion to Open Surgery
Mortality
Blood Group Antigens
Patient Selection
Length of Stay
Neoplasms
Multivariate Analysis
Survival Rate
Morbidity

Keywords

  • Conversion
  • Laparoscopic surgery
  • Rectal cancer

ASJC Scopus subject areas

  • Surgery

Cite this

Conversions in laparoscopic surgery for rectal cancer. / For the COLOR II study group.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 31, No. 5, 01.05.2017, p. 2263-2270.

Research output: Contribution to journalArticle

For the COLOR II study group. / Conversions in laparoscopic surgery for rectal cancer. In: Surgical Endoscopy and Other Interventional Techniques. 2017 ; Vol. 31, No. 5. pp. 2263-2270.
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abstract = "Background: Laparoscopic surgery offers patients with rectal cancer short-term benefits and similar survival rates as open surgery. However, selecting patients who are suitable candidates for laparoscopic surgery is essential to prevent intra-operative 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 surgery. Methods: Between 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 determined. Results: Factors correlating with conversion were as follows: age above 65 years (OR 1.9; 95 {\%} CI 1.2–3.0: p = 0.003), BMI greater than 25 (OR 2.7; 95 {\%} CI 1.7–4.3: p < 0.001), and tumor location more than 5 cm from the anal verge (OR 0.5; CI 0.3–0.9). Gender was not significantly related to conversion (p = 0.14). In the converted group, blood loss was greater (p < 0.001) and operating time was longer (p = 0.028) compared with the non-converted laparoscopies. Hospital stay did not differ (p = 0.06). Converted procedures were followed by more postoperative complications compared with laparoscopic or open surgery (p = 0.041 and p = 0.042, respectively). Mortality was similar in the laparoscopic and converted groups. Conclusions: Age above 65 years, BMI greater than 25, and tumor location between 5 and 15 cm from the anal verge were risk factors for conversion of laparoscopic to open surgery in patients with rectal cancer.",
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T1 - Conversions in laparoscopic surgery for rectal cancer

AU - For the COLOR II study group

AU - van der Pas, Martijn H.G.M.

AU - Deijen, Charlotte L.

AU - Abis, Gabor S.A.

AU - de Lange-de Klerk, Elly S.M.

AU - Haglind, Eva

AU - Fürst, Alois

AU - Lacy, Antonio M.

AU - Cuesta, Miguel A.

AU - Bonjer, Hendrik J.

AU - d’Hoore, André

AU - Birch, Dan

AU - DeGara, Chris

AU - Jamieson, Chris

AU - Peiman, Poornoroozy

AU - Jensen, Karl Juul

AU - Bulut, Orhan

AU - Jess, Per

AU - Rosenberg, Jacob

AU - Harvald, Thomas

AU - Ovesen, Henrik

AU - Iesalnieks, Igors

AU - Agha, Ayman

AU - Jaeger, Christina

AU - Kreis, Martin

AU - Kasparek, Michael

AU - Fürst, Alois

AU - Liebig-Hoerl, Gudrun

AU - Kim, Seon Hahn

AU - Kim, Seon Hahn

AU - van der Peet, Donald

AU - Cuesta, Miguel

AU - van der Pas, Martijn

AU - Buunen, Mark

AU - Abis, Gabor

AU - Deijen, Charlotte

AU - de Lange-de Klerk, Elly

AU - Hop, Wim

AU - Neijenhuis, Peter

AU - Coene, Peter Paul

AU - van der Harst, Edwin

AU - van ‘t Riet, Yvonne

AU - Bemelman, Willem

AU - Gerhards, Michael

AU - Prins, Hubert

AU - Targarona, Eduardo

AU - Balague, Carmen

AU - Martinez, Carmen

AU - Osorio, Juan Franco

AU - Molina, Garcia

AU - Lacy, Antonio

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background: Laparoscopic surgery offers patients with rectal cancer short-term benefits and similar survival rates as open surgery. However, selecting patients who are suitable candidates for laparoscopic surgery is essential to prevent intra-operative 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 surgery. Methods: Between 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 determined. Results: Factors correlating with conversion were as follows: age above 65 years (OR 1.9; 95 % CI 1.2–3.0: p = 0.003), BMI greater than 25 (OR 2.7; 95 % CI 1.7–4.3: p < 0.001), and tumor location more than 5 cm from the anal verge (OR 0.5; CI 0.3–0.9). Gender was not significantly related to conversion (p = 0.14). In the converted group, blood loss was greater (p < 0.001) and operating time was longer (p = 0.028) compared with the non-converted laparoscopies. Hospital stay did not differ (p = 0.06). Converted procedures were followed by more postoperative complications compared with laparoscopic or open surgery (p = 0.041 and p = 0.042, respectively). Mortality was similar in the laparoscopic and converted groups. Conclusions: Age above 65 years, BMI greater than 25, and tumor location between 5 and 15 cm from the anal verge were risk factors for conversion of laparoscopic to open surgery in patients with rectal cancer.

AB - Background: Laparoscopic surgery offers patients with rectal cancer short-term benefits and similar survival rates as open surgery. However, selecting patients who are suitable candidates for laparoscopic surgery is essential to prevent intra-operative 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 surgery. Methods: Between 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 determined. Results: Factors correlating with conversion were as follows: age above 65 years (OR 1.9; 95 % CI 1.2–3.0: p = 0.003), BMI greater than 25 (OR 2.7; 95 % CI 1.7–4.3: p < 0.001), and tumor location more than 5 cm from the anal verge (OR 0.5; CI 0.3–0.9). Gender was not significantly related to conversion (p = 0.14). In the converted group, blood loss was greater (p < 0.001) and operating time was longer (p = 0.028) compared with the non-converted laparoscopies. Hospital stay did not differ (p = 0.06). Converted procedures were followed by more postoperative complications compared with laparoscopic or open surgery (p = 0.041 and p = 0.042, respectively). Mortality was similar in the laparoscopic and converted groups. Conclusions: Age above 65 years, BMI greater than 25, and tumor location between 5 and 15 cm from the anal verge were risk factors for conversion of laparoscopic to open surgery in patients with rectal cancer.

KW - Conversion

KW - Laparoscopic surgery

KW - Rectal cancer

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