Does Conversion in Laparoscopic Colectomy Portend an Inferior Oncologic Outcome? Results from 104,400 Patients

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Babatunde A YerokunChristopher R Mantyh

Abstract

Limited data exist regarding the effect of conversion from laparoscopic to open colectomy on perioperative and oncologic outcomes in colon cancer. The National Cancer Data Base was used to identify patients who underwent colectomy for non-metastatic colon cancer (2010-2012). Patients were stratified into three groups: laparoscopic/robotic-assisted colectomy (MIC), converted colectomy (CC), and open colectomy (OC). Multivariable modeling was applied to compare outcomes from CC and MIC to OC while adjusting for patient, clinical, and tumor characteristics. Of 104,400 patients, 40,328 (38.6 %) underwent MIC, 57,928 (55.5 %) OC, and 6144 (5.9 %) CC. After adjustment, the rate of positive surgical margins was not significantly different between CC and OC (p = 0.44). However, with adjustment, CC versus OC was associated with shorter hospital length of stay (4 % decrease, 95 % CI 2-5 %, p < 0.0001) and lower odds of 30-day mortality (OR 0.77, 95 % CI 0.64-0.94, p = 0.0112). Adjusted overall survival was similar between CC and OC (p = 0.34). Conversion from laparoscopic to open colectomy was not associated with compromised oncologic outcomes, while maintaining improved short-term outcomes despite being attempted in only 45 % of patient...Continue Reading

References

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Citations

Oct 14, 2016·Surgical Endoscopy·Charlotte L DeijenUNKNOWN COLOR (COlon cancer Laparoscopic or Open Resection) study group
Dec 25, 2019·International Journal of Colorectal Disease·Sung Chul LeeJung Kyong Shin
Nov 16, 2016·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Mario SaiaVincenzo Baldo
Oct 13, 2016·World Journal of Gastroenterology : WJG·Marco E AllaixMario Morino
Sep 27, 2018·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·UNKNOWN 2017 and 2015 European Society of Coloproctology (ESCP) collaborating groups
Nov 6, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Qing HuangJie Cao
Dec 3, 2020·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·Carolin KastnerArmin Wiegering
Nov 23, 2018·The Journal of Surgical Research·Lieve G J LeijssenDavid L Berger
Jun 11, 2017·American Journal of Surgery·Mohamed Abdelgadir AdamChristopher R Mantyh

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