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Consequences of conversion in laparoscopic colorectal surgery.
Rodrigo Gonzalez1, C Daniel Smith, Edward Mason
1Emory Endosurgery Unit, Emory University School of Medicine, Atlanta, Georgia, USA.
Diseases of the Colon and Rectum
|December 6, 2005
Summary
Conversions from laparoscopic to open colorectal surgery have similar outcomes to open procedures, with fewer transfusions needed. Surgeons should consider laparoscopic colorectal resections despite high conversion rates.
Area of Science:
- Colorectal surgery
- Minimally invasive surgery
- Surgical outcomes
Background:
- Laparoscopic procedures converted to open surgery often have higher complication rates.
- Laparoscopic colorectal resections have a higher conversion rate compared to other laparoscopic procedures.
- This study evaluates outcomes of converted colorectal resections versus purely laparoscopic and open colorectal resections.
Purpose of the Study:
- To compare the operative outcomes of converted colorectal resections with those of purely laparoscopic and open colorectal resections.
- To determine if conversion from laparoscopic to open colorectal surgery impacts patient outcomes.
- To assess the safety and efficacy of laparoscopic colorectal resections, considering conversion rates.
Main Methods:
- A retrospective review of 498 consecutive colorectal resections performed between 1995 and 2002.
- Procedures were categorized into laparoscopic colorectal resections, open colorectal resections, and conversions.
- Demographics, disease characteristics, procedure type, and operative outcomes were compared across the three groups.
Main Results:
- Of 238 laparoscopic procedures, 56 (23%) were converted to open surgery.
- Conversions showed increased blood loss, longer time to first bowel movement, and longer hospital stays compared to laparoscopic colorectal resections.
- Conversions had fewer transfusions, shorter time to first bowel movement, and shorter hospital stays compared to open colorectal resections, with no significant differences in complications or mortality across groups.
Conclusions:
- Laparoscopic colorectal resections have a high conversion rate, but outcomes are comparable to open colorectal resections.
- Converted cases demonstrated fewer blood transfusions than open colorectal resections.
- Timely conversion, based on surgeon experience and judgment, is crucial for minimizing complications, supporting the consideration of laparoscopic colorectal resections.