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Factors that predict conversion in patients undergoing laparoscopic surgery for Crohn's disease
Krishna Moorthy1, Tracey Shaul, Robert J Foley
1Department of Surgery, Bedford Hospital, Bedford, England, United Kingdom. kmoorthy@ic.ac.uk
Background:
To identify factors that would predict conversion in patients undergoing laparoscopic surgery for Crohn's disease.
Methods:
Data were collected retrospectively. All procedures were performed by an experienced laparoscopic surgeon.
Results:
Forty-eight patients underwent 57 laparoscopic procedures. Twenty-six of these procedures were for recurrent disease. The conversion rate was 42.3% (11 of 26) for recurrent disease and 13% (4 of 31) for primary disease. On univariate analysis age (P = 0.02), surgery for recurrence (P = 0.02), time from diagnosis (P = 0.03), and the presence of a clinical mass (P = 0.03) were factors that predicted conversion. On multivariate analysis these factors except time from diagnosis still remained significant. Patients who did not undergo a conversion had significantly better post operative outcomes. There was no difference in the incidence of major or minor complications or the number of resections in both groups.
Conclusions:
The conversion rate for the whole group was 28%. The rate is higher in patients who are over 40 years of age who are undergoing procedures for recurrence.