Laparoscopic conversion is not associated with increased complications in patients with colon cancer

This study investigated whether laparoscopic conversion (LC) was associated with an increased complication rate when compared to planned open colon surgery. Researchers suggested that this treatment method is not associated with an increased risk of negative side effects.

Laparoscopic surgery is a less invasive method. It consists in inserting a tube with a camera through a small cut to remove the tumor. It is a safer method that is associated with less blood loss, faster return of bowel function and reduced length of hospital stay.

In some cases, during the procedure, surgeons can move from a laparoscopic to a classic, open surgery. This is called laparoscopic conversion (LC). This may be due to several factors including disease extension and tumor site. Early studies showed that LC was associated with more complications. However, surgeons and hospitals have now more experience performing LC, which might be related to fewer complications. It is important to determine if LC is associated with more complications than planned open surgery.

This study included information about 3980 patients with colon cancer. 1419 (36%) patients received planned open surgery. 2561 (64%) started the procedure with laparoscopic surgery. Of these 359 (14.7%) required LC. Complication rates were compared among the 3 groups.

The complication rate was higher after open surgery (11.6%) compared to LC (9.7%) and to completed laparoscopic surgery (7.4%). Patients who underwent planned open surgery were 64% more at risk of having a post-surgery complication compared to completed laparoscopic surgery. Patients who needed an LC were 24% more at risk of major complications.

This study determined that LC is not associated with an increased risk of complications when compared to open surgery.

The patients included came from 566 hospitals in 48 countries. Surgical procedures may have varied and this could have affected the results.