Analysis of Early and Long‐Term Oncologic Outcomes After Converted Laparoscopic Resection Compared to Primary Open Surgery for Rectal Cancer

Abstract

Conversion to open surgery does not impair short-term outcomes and does not jeopardize 5-year survival in patients with rectal cancer when compared to primary open surgery.

Conversion to Open Surgery in Laparoscopic Colorectal Cancer Resection: Predictive Factors and its Impact on Long-Term Outcomes. A Case Series Study

“…41 In our study we observed no differences between overall survival and disease-free survival between the 2 groups-a finding in line with several authors, 36,43 but different from those reporting a negative impact of conversions on long-term oncologic outcomes. 8,9,35 When survival was analyzed according to the location of the tumor (colon or rectum), we observed poorer survival in patients undergoing conversion in resections of the colon, although this did not reach statistical significance (P = 0.061), a result which is consistent with that from other studies. 36,43 There are various reasons which may explain the negative impact of conversions on oncologic outcomes.…”

“…Some authors have reported a negative impact of conversion on overall and disease-free survival while others have found no such differences. 8,9,[35][36][37][38] For this reason, we studied the risk factors associated with conversion to open surgery and their impact on operative morbidity and long-term oncologic outcomes.…”

“…In contrast, female sex was associated with a significantly lower likelihood of conversion, a result consistent with most studies. 8,9,35,42 These factors are available in the preoperative evaluation of the patient and allow the risk of conversion to open surgery to be predicted. 41 In our study we observed no differences between overall survival and disease-free survival between the 2 groups-a finding in line with several authors, 36,43 but different from those reporting a negative impact of conversions on long-term oncologic outcomes.…”

“…In the univariate analysis, age above 65 years, male sex, overweight/obesity, cardiovascular disease, left-sided location, fixed tumors, left resection, abdominoperineal amputation, greater use of crystalloids and volume expanders, longer hospital stay, incidence of wound infection and incidence of complications were all associated with conversion to open surgery-findings common to most series. 8,35,41 In the multivariate analysis, 3 independent variables were associated with a higher rates of conversion: left resections, resections of the rectum, and local invasion. In contrast, female sex was associated with a significantly lower likelihood of conversion, a result consistent with most studies.…”

Resultados a corto plazo, recurrencia local, supervivencia global y calidad de vida en pacientes intervenidos de cáncer de recto: Revisión sistemática comparativa entre abordaje abierto y laparoscópico.

“…Por lo que aconsejan, intentar el abordaje laparoscópico incluso en aquellos pacientes con cáncer de recto con factores preoperatorios de riesgo para la conversión 67 .…”