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Article: Impact of conversion on the long-term outcome in laparoscopic resection of colorectal cancer

TitleImpact of conversion on the long-term outcome in laparoscopic resection of colorectal cancer
Authors
KeywordsCancer
Conversion
Laparoscopic colectomy
Outcome
Issue Date2008
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/
Citation
Surgical Endoscopy And Other Interventional Techniques, 2008, v. 22 n. 12, p. 2625-2630 How to Cite?
AbstractBackground: Long-term outcome of patients with conversion following laparoscopic resection of colorectal cancer has seldom been reported. This study aimed to evaluate the impact of conversion on the operative outcome and survival of patients who underwent laparoscopic resection for colorectal malignancy. Methods: An analysis of a prospectively collected database of 470 patients who underwent laparoscopic colectomy between May 2000 and December 2006 was performed. The operative results and long-term outcomes of patients with conversion were compared with those with successful laparoscopic operations. Results: The overall conversion rate to open surgery was 8.7% (41 patients). There was no difference in age, comorbid illness, location of tumor, and stage of disease between the laparoscopic and conversion groups. The most common reasons for conversion include adhesions (34.1%), tumor invasion into adjacent structures (17.1%), bulky tumor (9.8%), and uncontrolled hemorrhage (9.8%). A male preponderance was observed in the conversion group. Tumor size was significantly larger in the conversion group compared with the laparoscopic group (5 versus 4 cm, P = 0.002). Although there was no difference in the operative time between the two groups, increased perioperative blood loss (461.9 vs. 191.2 ml, P < 0.001), increased postoperative complication rate (56.1% versus 16.7%, P = 0.001) and prolonged median hospital stay (10 versus 6 days, P < 0.001) were associated with the conversion group. Consequently, patients in the conversion group were more likely to develop local recurrence (9.8% versus 2.8%, P < 0.001) with a significantly reduced cumulative cancer-free survival. Conclusion: The disease-free survival and the local recurrence were significantly worse by the presence of conversion in laparoscopic resection for colorectal malignancy. Adoption of a standardized operative strategy may improve the perioperative outcome after conversion. © 2008 Springer Science+Business Media, LLC.
Persistent Identifierhttp://hdl.handle.net/10722/125419
ISSN
2015 Impact Factor: 3.54
2015 SCImago Journal Rankings: 1.695
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, ACYen_HK
dc.contributor.authorPoon, JTCen_HK
dc.contributor.authorFan, JKMen_HK
dc.contributor.authorLo, SHen_HK
dc.contributor.authorLaw, WLen_HK
dc.date.accessioned2010-10-31T11:30:22Z-
dc.date.available2010-10-31T11:30:22Z-
dc.date.issued2008en_HK
dc.identifier.citationSurgical Endoscopy And Other Interventional Techniques, 2008, v. 22 n. 12, p. 2625-2630en_HK
dc.identifier.issn0930-2794en_HK
dc.identifier.urihttp://hdl.handle.net/10722/125419-
dc.description.abstractBackground: Long-term outcome of patients with conversion following laparoscopic resection of colorectal cancer has seldom been reported. This study aimed to evaluate the impact of conversion on the operative outcome and survival of patients who underwent laparoscopic resection for colorectal malignancy. Methods: An analysis of a prospectively collected database of 470 patients who underwent laparoscopic colectomy between May 2000 and December 2006 was performed. The operative results and long-term outcomes of patients with conversion were compared with those with successful laparoscopic operations. Results: The overall conversion rate to open surgery was 8.7% (41 patients). There was no difference in age, comorbid illness, location of tumor, and stage of disease between the laparoscopic and conversion groups. The most common reasons for conversion include adhesions (34.1%), tumor invasion into adjacent structures (17.1%), bulky tumor (9.8%), and uncontrolled hemorrhage (9.8%). A male preponderance was observed in the conversion group. Tumor size was significantly larger in the conversion group compared with the laparoscopic group (5 versus 4 cm, P = 0.002). Although there was no difference in the operative time between the two groups, increased perioperative blood loss (461.9 vs. 191.2 ml, P < 0.001), increased postoperative complication rate (56.1% versus 16.7%, P = 0.001) and prolonged median hospital stay (10 versus 6 days, P < 0.001) were associated with the conversion group. Consequently, patients in the conversion group were more likely to develop local recurrence (9.8% versus 2.8%, P < 0.001) with a significantly reduced cumulative cancer-free survival. Conclusion: The disease-free survival and the local recurrence were significantly worse by the presence of conversion in laparoscopic resection for colorectal malignancy. Adoption of a standardized operative strategy may improve the perioperative outcome after conversion. © 2008 Springer Science+Business Media, LLC.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/en_HK
dc.relation.ispartofSurgical Endoscopy and Other Interventional Techniquesen_HK
dc.rightsThe original publication is available at www.springerlink.com-
dc.subjectCanceren_HK
dc.subjectConversionen_HK
dc.subjectLaparoscopic colectomyen_HK
dc.subjectOutcomeen_HK
dc.subject.meshAdenocarcinoma - mortality - pathology - surgery-
dc.subject.meshColectomy - methods-
dc.subject.meshColorectal Neoplasms - mortality - pathology - surgery-
dc.subject.meshLaparoscopy - statistics and numerical data-
dc.subject.meshLaparotomy - statistics and numerical data-
dc.titleImpact of conversion on the long-term outcome in laparoscopic resection of colorectal canceren_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0930-2794&volume=22&issue=12&spage=2625&epage=2630&date=2008&atitle=Impact+of+conversion+on+the+long-term+outcome+in+laparoscopic+resection+of+colorectal+cancer-
dc.identifier.emailChan, ACY: acchan@hku.hken_HK
dc.identifier.emailPoon, JTC: tcjensen@hkucc.hku.hken_HK
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hken_HK
dc.identifier.authorityChan, ACY=rp00310en_HK
dc.identifier.authorityPoon, JTC=rp01603en_HK
dc.identifier.authorityLaw, WL=rp00436en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00464-008-9813-3en_HK
dc.identifier.pmid18297346-
dc.identifier.scopuseid_2-s2.0-56349099157en_HK
dc.identifier.hkuros175042en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-56349099157&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume22en_HK
dc.identifier.issue12en_HK
dc.identifier.spage2625en_HK
dc.identifier.epage2630en_HK
dc.identifier.eissn1432-2218-
dc.identifier.isiWOS:000262089200015-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChan, ACY=15828849100en_HK
dc.identifier.scopusauthoridPoon, JTC=7005903722en_HK
dc.identifier.scopusauthoridFan, JKM=23484820100en_HK
dc.identifier.scopusauthoridLo, SH=15518872700en_HK
dc.identifier.scopusauthoridLaw, WL=7103147867en_HK

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