Short- and long-term outcomes of conversion in laparoscopic gastrectomy for gastric cancer

In laparoscopic gastrectomy (LG) for gastric cancer, conversion to open gastrectomy may sometimes be unavoidable. This study aimed to investigate the short-term and long-term outcomes of conversion from LG to open gastrectomy in patients with gastric cancer.

Patients with gastric cancer who underwent LG from January 2010 to December 2016 were included in this study. Patients were divided into a laparoscopic group and a conversion group based on the occurrence of conversion to open gastrectomy during LG. We carried out a retrospective analysis of the clinical and follow-up data of patients. Univariate and multivariate analysis were carried out on factors affecting prognosis.

In this study, the conversion rate of patients was 8%. The most common reason for conversion to open gastrectomy was bleeding, followed by adhesions. Compared with those in the laparoscopic group, the conversion group had longer operation time, greater intraoperative blood loss, longer time to first flatus and longer hospitalization time. They also had higher incidence of postoperative complications, but the rates of major complications were similar in both groups. Patients in both groups had similar pathological results. During the follow-up period, the tumor recurrence rates in both groups were similar. There were no statistical differences in the 5-year overall survival (OS) and 5-year disease-free survival (DFS) in both groups. On multivariate analysis, tumor invasion depth and lymph node metastasis were independent predictors of OS. Tumor invasion depth, lymph node metastasis, and cancer differentiation were independent predictors of DFS.

The long-term outcomes of patients with gastric cancer who were converted to open gastrectomy during LG are similar to those who did not undergo conversion.