Impacts of Conversion to Open in Laparoscopic Rectal Cancer Radical Resection on Postoperative Recovery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHONG Keli ¹ , PAN Kai ¹ , XIA Ligang ¹ , LI Mingwei ¹ , LIN Liewen ¹ , ZHOU Hanxin ¹ , WANG Chunyou ²

1.Department of Gastrointestinal Surgery， Shenzhen People’s Hospital, The Second Clinical Medicine College of Jinan University, Shenzhen 518020, China;;
2.Department of General Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, ChinaCorresponding Author: ZHONG Ke-li, E-mail: zhongkeli@126.com;

Corresponding author：

Keywords：

Laparoscopy; Rectal cancer radical resection; Conversion to open surgery

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Objective 　To investigate the impact of conversion to open in laparoscopic rectal cancer radical resection (LRR) on postoperative recovery.
Methods 　The data from Feb. 2003 to Feb. 2007 of 176 cases who were given LRR and 32 cases receiving conversion in LRR (CRR) were analyzed retrospectively, and were compared about operation time, hospitalization time, hospitalization expenses, intraoperative blood loss, recovery time of bowel movement and postoperative complications with 59 cases of open rectal cancer radical resection (ORR).
Results 　There were no differences among LRR, CRR and ORR about operation time, hospitalization time, intraoperative blood loss and recovery time of bowel movement (P gt;0.05). The hospitalization expenses of LRR and CRR were higher than that of ORR (P=0.001, P=0.001), there was no difference between CRR and LRR (P=0.843). But the postoperative complications rate of ORR was higher than those of LRR and CRR （P=0.023,P=0.004）.
Conclusion 　Compared with ORR, LRR has relatively conversion rate, and then increases the hospitalization expenses.

Citation： ZHONG Keli,PAN Kai,XIA Ligang,LI Mingwei,LIN Liewen,ZHOU Hanxin,WANG Chunyou. Impacts of Conversion to Open in Laparoscopic Rectal Cancer Radical Resection on Postoperative Recovery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(4): 311-313. doi: Copy

1.	Delaney CP, Kiran RP, Senagore AJ, et al. Case-matched comparison of clinical and financial outcome after laparoscopic or open colorectal surgery [Ｊ]. Ann Surg, 2003; 238(1): 67-72.
2.	Braga M, Vignali A, Gianotti L, et al. Laparoscopic versus open colorectal surgery: a randomized trial on short-term outcome [Ｊ]. Ann Surg, 2002; 236(6): 759-767.
3.	卿三华，巴明臣. 我国腹腔镜直肠癌根治术的现状和展望 [Ｊ]. 中国普外基础与临床杂志， 2005； 12(6): 540-541.
4.	李军，丁克峰，张苏展. 结直肠癌患者经腹腔镜手术后短期疗效和安全性的荟萃分析 [Ｊ]. 中华医学杂志, 2006; 86(35): 2485-2490.
5.	池畔，林惠铭. 腹腔镜结直肠癌根治术学习曲线 [Ｊ]. 中华胃肠外科杂志, 2004; 7(5): 372-374.
6.	Schlachta CM, Mamazza J, Seshadri PA, et al. Defining a learning curve for laparoscopic colorectal resections [Ｊ]. Dis Colon Rectum, 2001; 44(2): 217-222.
7.	江志伟，黎介寿. 结直肠癌手术腹腔镜或开腹术式选择的争论 [Ｊ]. 中国实用外科杂志， 2008； 28(6): 453-455.
8.	郑民华，李健文，陆爱国, 等. 腹腔镜结直肠手术的学习曲线 [Ｊ]. 外科理论与实践， 2002； 7(3): 187-189.
9.	Guillou PJ, Quirke P, Thorpe H, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial [Ｊ]. Lancet, 2005; 365(9472): 1718-1726.
10.	Slim K, Pezet D, Riff Y, et al. High morbidity rate after converted laparoscopic colorectal surgery [Ｊ]. Br J Surg, 1995; 82(10): 1406-1408.
11.	于永扬，王存，周总光. 腹腔镜下结直肠癌手术(四) [Ｊ]. 中国普外基础与临床杂志， 2008； 15(7): 533-535.
12.	中华抗癌协会大肠癌专业委员会腹腔镜外科学组，中华医学会外科学分会腹腔镜与内镜学组. 腹腔镜结肠直肠癌根治手术操作指南（2006版） [Ｊ]. 外科理论与实践， 2006； 11（5）: 462-464.
13.	Gervaz P, Pikarsky A, Utech M, et al. Converted laparoscopic colorectal surgery [Ｊ]. Surg Endosc, 2001; 15(8): 827-832.
14.	Lauter DM, Froines EJ. Initial experience with 150 cases of laparoscopic assisted colectomy [Ｊ]. Am J Surg, 2001; 181(5): 398-403.
15.	Aziz O, Constantinides V, Tekkis PP, et al. Laparoscopic versus open surgery for rectal cancer: a meta-analysis [Ｊ]. Ann Surg Oncol, 2006; 13(3): 413-424.
16.	Fukunaga Y, Higashino M, Tanimura S, et al. Laparoscopic colorectal surgery for neoplasm. A large series by a single surgeon [Ｊ]. Surg Endosc, 2008; 22(6): 1452-1483.
17.	Montreuil B, Bendavid Y. Laparoscopic colorectal surgery in elderly patients: a matched case-control study in 178 patients [Ｊ]. J Am Coll Surg, 2008; 207(1): 141-142.
18.	Lordan JT, Tilney HS, Shirol S, et al. Does the laparoscopic colorectal surgery learning curve adversely affect the results of colorectal cancer resection? A 3-year prospective study in a district general hospital [Ｊ]. Colorectal Dis, 2008; 10(4): 363-369.
19.	Jamali FR, Soweid AM, Dimassi H, et al. Evaluating the degree of difficulty of laparoscopic colorectal surgery [Ｊ]. Arch Surg, 2008; 143(8): 762-767.

1. Delaney CP, Kiran RP, Senagore AJ, et al. Case-matched comparison of clinical and financial outcome after laparoscopic or open colorectal surgery [Ｊ]. Ann Surg, 2003; 238(1): 67-72.
2. Braga M, Vignali A, Gianotti L, et al. Laparoscopic versus open colorectal surgery: a randomized trial on short-term outcome [Ｊ]. Ann Surg, 2002; 236(6): 759-767.
3. 卿三华，巴明臣. 我国腹腔镜直肠癌根治术的现状和展望 [Ｊ]. 中国普外基础与临床杂志， 2005； 12(6): 540-541.
4. 李军，丁克峰，张苏展. 结直肠癌患者经腹腔镜手术后短期疗效和安全性的荟萃分析 [Ｊ]. 中华医学杂志, 2006; 86(35): 2485-2490.
5. 池畔，林惠铭. 腹腔镜结直肠癌根治术学习曲线 [Ｊ]. 中华胃肠外科杂志, 2004; 7(5): 372-374.
6. Schlachta CM, Mamazza J, Seshadri PA, et al. Defining a learning curve for laparoscopic colorectal resections [Ｊ]. Dis Colon Rectum, 2001; 44(2): 217-222.
7. 江志伟，黎介寿. 结直肠癌手术腹腔镜或开腹术式选择的争论 [Ｊ]. 中国实用外科杂志， 2008； 28(6): 453-455.
8. 郑民华，李健文，陆爱国, 等. 腹腔镜结直肠手术的学习曲线 [Ｊ]. 外科理论与实践， 2002； 7(3): 187-189.
9. Guillou PJ, Quirke P, Thorpe H, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial [Ｊ]. Lancet, 2005; 365(9472): 1718-1726.
10. Slim K, Pezet D, Riff Y, et al. High morbidity rate after converted laparoscopic colorectal surgery [Ｊ]. Br J Surg, 1995; 82(10): 1406-1408.
11. 于永扬，王存，周总光. 腹腔镜下结直肠癌手术(四) [Ｊ]. 中国普外基础与临床杂志， 2008； 15(7): 533-535.
12. 中华抗癌协会大肠癌专业委员会腹腔镜外科学组，中华医学会外科学分会腹腔镜与内镜学组. 腹腔镜结肠直肠癌根治手术操作指南（2006版） [Ｊ]. 外科理论与实践， 2006； 11（5）: 462-464.
13. Gervaz P, Pikarsky A, Utech M, et al. Converted laparoscopic colorectal surgery [Ｊ]. Surg Endosc, 2001; 15(8): 827-832.
14. Lauter DM, Froines EJ. Initial experience with 150 cases of laparoscopic assisted colectomy [Ｊ]. Am J Surg, 2001; 181(5): 398-403.
15. Aziz O, Constantinides V, Tekkis PP, et al. Laparoscopic versus open surgery for rectal cancer: a meta-analysis [Ｊ]. Ann Surg Oncol, 2006; 13(3): 413-424.
16. Fukunaga Y, Higashino M, Tanimura S, et al. Laparoscopic colorectal surgery for neoplasm. A large series by a single surgeon [Ｊ]. Surg Endosc, 2008; 22(6): 1452-1483.
17. Montreuil B, Bendavid Y. Laparoscopic colorectal surgery in elderly patients: a matched case-control study in 178 patients [Ｊ]. J Am Coll Surg, 2008; 207(1): 141-142.
18. Lordan JT, Tilney HS, Shirol S, et al. Does the laparoscopic colorectal surgery learning curve adversely affect the results of colorectal cancer resection? A 3-year prospective study in a district general hospital [Ｊ]. Colorectal Dis, 2008; 10(4): 363-369.
19. Jamali FR, Soweid AM, Dimassi H, et al. Evaluating the degree of difficulty of laparoscopic colorectal surgery [Ｊ]. Arch Surg, 2008; 143(8): 762-767.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Impacts of Conversion to Open in Laparoscopic Rectal Cancer Radical Resection on Postoperative Recovery

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