The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit

• Published in: Colorectal disease 2018-09, Vol.20 (S6), p.69-89
• Main Authors: Glasbey, James, Buchs, Nicolas, El‐Hussuna, Alaa, Buchs, Nicolas C., Zmora, Oded, Van Langenhove, K., Kenjic, B., Delibegovic, S., Sokolov, M., Batashki, I., Grolich, T., El Sorogy, M., Elgeidie, A., Awny, S., Ahonen‐Siirtola, M., Cotte, E., Theodosopoulos, T., Zervakis, N., Papadopoulos, G., Karavokyros, I., Manatakis, D., Burány, Á., Gupta, S., Coveney, A., McNamara, D., Edden, Y., Andriola, V., Spinelli, A., Di Candido, F., Vignali, A., Luzzi, A., Pezzolla, F., Colombo, F., Romano, G. M., Pertusati, A., Oldani, M., Salamone, G., Sacco, R., Bauce, S., Majbar, M. A., Koeter, T., de Graaf, E., van Oorschot, N., Keijzers, M., Wang, X., Romaniszyn, M., Rzaca, M., Costa, S., Insua, C., Romero, I., Fernandes, P., Pires, C., Vilela, N., Frois Borges, M., Lebedev, K., Dimitrijević, I., Lukic, D., Ngu, J. C., Tomazic, A., Ferreras García, C., Vicente‐Ruiz, M., Paredes‐Quiles, M., Escartin, J., Rius, J., Colao, L., Forero‐Torres, A., Alcalá Serrano, F. J., Maristany, C., Rada‐Palomino, A., Parra Baños, P. A., Lage Laredo, A., Gómez Pérez, R., Escuder, J., Caravaca‐García, I., Frasson, M., Alonso, J., Lydrup, M‐L., Smedh, K., Freil‐Lanter, C., Müller, P., Karip, B., Kalayci, M. U., Isik, O., Arnold, S., Chowdhary, M., Stubbs, B., Thavanesan, N., Agarwal, T., Patel, P., Bradley, N., Voll, J., Kelkar, A., Al‐Saeedi, M., Ather, S., Symankewicz, M., Gokul, K., Garg, A., Ramsanahie, A., Pandey, S., Sharma, A.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anastomosis; Clinical Medicine; Colectomy/adverse effects; Colon cancer; Complications; Conversion to Open Surgery/adverse effects; Elective Surgical Procedures/adverse effects; Female; gastrointestinal surgery; Humans; Kirurgi; Klinisk medicin; laparoscopic surgery; Laparoscopy; Laparoscopy/adverse effects; Male; Medical and Health Sciences; Medical Audit; Medicin och hälsovetenskap; Middle Aged; Patients; Postoperative Complications/epidemiology; Prospective Studies; rectal cancer; Surgery; Treatment Outcome
• ISSN: 1462-8910; 1463-1318; 1463-1318
• DOI: 10.1111/codi.14371

Background Laparoscopy has now been implemented as a standard of care for elective colonic resection around the world. During the adoption period, studies showed that conversion may be detrimental to patients, with poorer outcomes than both laparoscopic completed or planned open surgery. The primary aim of this study was to determine whether laparoscopic conversion was associated with a higher major complication rate than planned open surgery in contemporary, international practice. Methods Combined analysis of the European Society of Coloproctology 2017 and 2015 audits. Patients were included if they underwent elective resection of a colonic segment from the caecum to the rectosigmoid junction with primary anastomosis. The primary outcome measure was the 30‐day major complication rate, defined as Clavien‐Dindo grade III‐V. Results Of 3980 patients, 64% (2561/3980) underwent laparoscopic surgery and a laparoscopic conversion rate of 14% (359/2561). The major complication rate was highest after open surgery (laparoscopic 7.4%, converted 9.7%, open 11.6%, P