Back to Annual Meeting Posters

Background: Laparoscopic colorectal surgery has comparable oncologic outcomes compared to open resections for cancer. The outcomes in patients undergoing laparoscopic conversions have been questioned by conflicting reports. In a previous report published in 2008 we found no change in overall survival in patients undergoing conversion of a laparoscopic procedure for colorectal carcinoma. However, the long-term outcomes are still uncertain due to limited number of publications. The present study is a 10-year follow-up of prospectively collected database to evaluate the effect of conversion on long-term survival.
Methods: A retrospective review of prospectively collected database of patients undergoing laparoscopic resection for colorectal cancer between January 1998 and June 2009 in a single institution. The cohort was divided into two groups: patients with successfully completed laparoscopic colectomy (LAP) and those whose colectomy was converted to open (CON). Only patients with stages 1-3 were included. Patients with metastatic diseases where excluded from the study. The overall survival was compared using Kaplan-Meier analysis.
Results: A total of 425 patients were divided into 388 in the LAP group and 37 in CON group. There was no difference in age, gender, stage, number of harvested nodes and length of follow up between two groups (p>0.288). There was a significant increase in median blood loss for CON group (350 ml vs. 100ml; p < 0.001), increased length of procedure (135 vs. 109.5min; p < 0.001) and increased length of hospital stay in CON group (6 vs. 3 days; p<0.001). Survival at 2, 3 and 5 years was: 84%, 79%, and 72%, respectively for the LAP group and 70%, 68%, and 62% in the CON group (Long-rank test: 0.016)
Conclusion: The results of this study propose that there may be a survival disadvantage in patients requiring a conversion for laparoscopic resection for colorectal malignancy.