Risk Factors for Conversion and Morbidity During Initial Experience in Laparoscopic Proctectomies: a Retrospective...

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Laparoscopic proctectomy is a key procedure for rectal adenocarcinoma.
• Identifying factors influencing conversion and morbidity is crucial for training and patient selection.

Purpose of the Study:

• To determine predictive factors for conversion and postoperative morbidity in laparoscopic proctectomies for rectal adenocarcinoma.
• To identify optimal patient candidates for surgeons beginning laparoscopic proctectomies.

Main Methods:

• Retrospective analysis of 69 patients undergoing laparoscopic rectal resection for rectal adenocarcinoma (2005-2012).
• Univariate and multivariate analyses were used to identify predictive factors for conversion and postoperative morbidity.

Main Results:

• The overall conversion rate was 17.4%.
• Independent predictive factors for conversion included earlier time period (before 2009) and tumors located >8 cm from the anal verge.
• Male gender was the only factor associated with increased postoperative complications (31.9% overall).

Conclusions:

• Conversion rates in laparoscopic proctectomies are influenced by surgeon experience and tumor height.
• Male gender is a predisposing factor for higher postoperative morbidity.
• Women with low rectal tumors are suitable candidates for early surgical experience in this procedure.