Impact of Conversion to Open Surgery on Early Postoperative Morbidity After Laparoscopic Resection for Rectal Adenocarcinoma: A Retrospective Study
| العنوان: | Impact of Conversion to Open Surgery on Early Postoperative Morbidity After Laparoscopic Resection for Rectal Adenocarcinoma: A Retrospective Study |
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| المؤلفون: | Mohamed Ahallat, Mourad Abid, Mouna Alaoui, Anass Mohammed Majbar, Abdelmalek Hrora, Mohamed Raiss, Farid Sabbah |
| المصدر: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 26:697-701 |
| بيانات النشر: | Mary Ann Liebert Inc, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Adult, Male, Reoperation, medicine.medical_specialty, Time Factors, Multivariate analysis, Anastomotic Leak, Adenocarcinoma, Conversion to open surgery, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, medicine, Rectal Adenocarcinoma, Humans, Laparoscopic resection, Postoperative Period, Laparoscopy, Aged, Retrospective Studies, medicine.diagnostic_test, Rectal Neoplasms, business.industry, Mortality rate, Retrospective cohort study, Middle Aged, medicine.disease, Conversion to Open Surgery, Tumor Burden, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, business |
| الوصف: | The impact of conversion to open surgery after a laparoscopic resection for rectal adenocarcinoma on postoperative morbidity is still unclear. Most previous studies included colon and rectal carcinomas and produced conflicting results. The aim of this study was to investigate the impact of conversion to open surgery on early postoperative morbidity in patients who underwent a laparoscopic resection for rectal adenocarcinoma.This was a retrospective bicentric study. It included all consecutive patients who underwent a laparoscopic resection for nonmetastatic rectal adenocarcinoma between January 2005 and December 2013. The impact of conversion to open surgery on 30-day postoperative morbidity was analyzed by univariate and multivariate analyses. Risk factors for conversion were also investigated by univariate and multivariate analyses.One hundred thirty-one patients were included. The conversion rate was 26.7%. The global 30-day morbidity rate was 31.3% (41 patients). The conversion to open surgery was associated with higher rates of postoperative complications, anastomotic leaks, and reoperations. It was also an independent predictive factor to postoperative morbidity in the multivariate analysis (P = .01; odds ratio 2.86; 95% confidence interval [CI] 1.23-6.63), in addition to T4 tumors (P = .04; odds ratio 3.92; 95% CI 1.05-14.61). Risk factors for conversion in the multivariate analysis were T4 tumors (P = .006; odds ratio 6.09; 95% CI 1.66-22.32) and the height of the tumor (P = .025; odds ratio 2.7; 95% CI 1.13-6.43).This study showed that conversion to open surgery after laparoscopic proctectomy for rectal adenocarcinoma was associated with higher rates of early postoperative complications. It also showed that T4 tumors and the height of the tumor were independent factors associated with the conversion to open surgery. Reducing postoperative morbidity could be achieved by a better patient selection and a policy of early conversion. |
| تدمد: | 1557-9034 1092-6429 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::290445360eae66d24e9dd67e0e34f950 https://doi.org/10.1089/lap.2016.0027 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....290445360eae66d24e9dd67e0e34f950 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15579034 10926429 |
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