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Colorectal Dis. 2018 Sep;20 Suppl 6:69-89. doi: 10.1111/codi.14371.

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

Collaborators (1367)

Glasbey J, van der Pool A, Rawlings A, Sánchez-Guillén L, Kuiper S, Negoi I, Buchs N, El-Hussuna A, Battersby NJ, Buchs NC, Buskens C, Chaudri S, Frasson M, Gallo G, Minaya-Bravo AM, Morton D, Nepogodiev D, Pata F, Singh B, Zmora O, Perry R, Magill L, Altomare D, Bemelman W, Brown S, Denost CBQ, Knowles C, Laurberg S, Lefevre JH, Möeslein G, Pinkney T, Vaizey C, Bilali S, Bilali V, Salomon M, Cillo M, Estefania D, Patron Uriburu J, Ruiz H, Farina P, Carballo F, Guckenheimer S, Proud D, Brouwer R, Bui A, Nguyen B, Smart P, Warwick A, Theodore JE, Herbst F, Birsan T, Dauser B, Ghaffari S, Hartig N, Stift A, Argeny S, Unger L, Strouhal R, Heuberger A, Varabei A, Lahodzich N, Makhmudov A, Selniahina L, Feryn T, Leupe T, Maes L, Reynvoet E, Van Langenhove K, Nachtergaele M, Monami B, Francart D, Jehaes C, Markiewicz S, Weerts J, Van Belle K, Bomans B, Cavenaile V, Nijs Y, Vertruyen M, Pletinckx P, Claeys D, Defoort B, Muysoms F, Van Cleven S, Lange C, Vindevoghel K, Wolthuis A, D'Hoore A, Todorovic M, Dabic S, Kenjic B, Lovric S, Vidovic J, Delibegovic S, Mehmedovic Z, Christiano A, Lombardi B, Marchiori M Jr, Tercioti V Jr, Dardanov D, Petkov P, Simonova L, Yonkov A, Zhivkov E, Maslyankov S, Pavlov V, Sokolov M, Todorov G, Stoyanov V, Batashki I, Iarumov N, Lozev I, Moshev B, Slavchev M, Atanasov B, Belev N, Krstev P, Penkov R, Šantak G, Ćosić J, Previšić A, Vukušić L, Zukanović G, Zelić M, Kršul D, Lekić Vitlov V, Mendrila D, Orhalmi J, Dusek T, Maly O, Paral J, Sotona O, Skrovina M, Bencurik V, Machackova M, Kala Z, Farkašová M, Grolich T, Procházka V, Hoch J, Kocian P, Martinek L, Antos F, Pruchova V, El-Hussuna A, Ceccotti A, Madsbøll T, Straarup D, Uth Ovesen A, Christensen P, Bondeven P, Edling P, Elfeki H, Alexandrovich Gameza V, Michelsen Bach S, Zheltiakova I, Krarup PM, Krogh A, Rolff HC, Lykke J, Juvik AF, Lóven HHK, Marckmann M, Osterkamp JTF, Madsen AH, Worsøe J, Ugianskis A, Kjaer MD, Youn Cho Lee B, Khalid A, Kristensen MH, El Sorogy M, Elgeidie A, Elhemaly M, El Nakeeb A, Elrefai M, Shalaby M, Emile S, Omar W, Sakr A, Thabet W, Awny S, Metwally I, Refky B, Shams N, Zuhdy M, Lepistö A, Keränen I, Kivelä A, Lehtonen T, Siironen P, Rautio T, Ahonen-Siirtola M, Klintrup K, Paarnio K, Takala H, Hyöty M, Haukijärvi E, Kotaluoto SM, Lehto K, Tomminen T, Huhtinen H, Carpelan A, Karvonen J, Rantala A, Varpe P, Cotte E, Francois Y, Glehen O, Passot G, d'Alessandro A, Chouillard E, Etienne JC, Ghilles E, Vinson-Bonnet B, Germain A, Ayav A, Bresler L, Chevalier R, Denost Q, Didailler R, Rullier E, Tiret E, Chafai N, Lefevre JH, Parc Y, Sielezneff I, Mege D, Lakkis Z, Barussaud M, Krones C, Bock B, Webler R, Baral J, Lang T, Münch S, Pullig F, Schön M, Hinz S, Becker T, Möller T, Richter F, Schafmayer C, Hardt J, Kienle P, Crescenti F, Ahmad M, Soleiman Y, Papaconstantinou I, Gklavas A, Nastos K, Theodosopoulos T, Vezakis A, Stamou K, Saridaki A, Xynos E, Paraskakis S, Zervakis N, Skroubis G, Amanatidis T, Germanos S, Maroulis I, Papadopoulos G, Dimitriou N, Alexandrou A, Felekouras E, Griniatsos J, Karavokyros I, Papadopoulos A, Chouliaras C, Ioannidis P, Katsounis D, Kefalou E, Katsoulis IE, Balalis D, Korkolis DP, Manatakis D, Tzovaras G, Baloyiannis I, Mamaloudis I, Lázár G, Ábraham S, Paszt A, Simonka Z, Tóth I, Zaránd A, Baranyai Z, Ferreira G, Harsányi L, Ónody P, Banky B, Burány Á, Lakatos M, Marton J, Solymosi A, Besznyák I, Bursics A, Papp G, Saftics G, Svastics I, Valsdottir E, Atladottir J, Jonsson T, Moller P, Sigurdsson H, Gupta SK, Gupta S, Kaul N, Mohan S, Sharma G, Wani R, Chowdri N, Khan M, Mehraj A, Parray FQ, Coveney A, Burke J, Deasy J, El-Masry S, McNamara D, Khan MF, Cahill R, Faul E, Mulsow J, Shields C, Kelly ME, Bass G, Martin ST, O'Connell R, Ryan E, Connelly T, Ahmad G, Bukhari W, Cooke F, Zmora O, Gold Deutch R, Haim N, Lavy R, Moscovici A, Shussman N, Gefen R, Marom G, Pikarsky A, Weiss D, Avital S, Hermann N, Raguan B, Slavin M, White I, Wasserberg N, Arieli H, Gurevich N, Freund MR, Dorot S, Edden Y, Halfteck G, Reissman P, Edden Y, Pery R, Tulchinsky H, Weizman A, Agresta F, Curinga R, Finotti E, Savino G, Verza LA, Asteria CR, Boccia L, Pascariello A, Tamini N, Bugatti A, Gianotti L, Totis M, Vincenti L, Andriola V, Giannini I, Travaglio E, Balestri R, Buccianti P, Roffi N, Rossi E, Urbani L, Mellano A, Cinquegrana A, Lauretta A, Belluco C, Mistrangelo M, Allaix ME, Arolfo S, Morino M, Testa V, Delrio P, Pace U, Rega D, Scala D, Gallo G, Clerico G, Cornaglia S, Realis Luc A, Trompetto M, Ugolini G, Antonacci N, Fabbri S, Montroni I, Zattoni D, D'Urbano C, Cornelli A, Viti M, Inama M, Bacchion M, Casaril A, Impellizzeri H, Moretto G, Spinelli A, Carvello M, David G, Di Candido F, Sacchi M, Frontali A, Ceriani V, Molteni M, Rosati R, Aleotti F, Elmore U, Lemma M, Vignali A, Scabini S, Casoni Pattacini G, Luzzi A, Romairone E, Marino F, Lorusso D, Pezzolla F, Colombo F, Baldi C, Foschi D, Sampietro G, Sorrentino L, Di Saverio S, Birindelli A, Segalini E, Spacca D, Romano GM, Belli A, Bianco F, De Franciscis S, Falato A, Muratore A, Marsanic P, Grimaldi S, Castaldo N, Ciolli MG, Picarella P, Porfidia R, Tugnoli G, Bondurri A, Cavallo D, Maffioli A, Pertusati A, Pulighe F, Balestra F, De Nisco C, Podda M, Opocher E, Longhi M, Mariani NM, Maroni N, Pisani Ceretti A, Galleano R, Aonzo P, Curletti G, Reggiani L, Marconi M, Del Prete L, Oldani M, Pappalardo R, Zaccone L S, Scatizzi M, Baraghini M, Cantafio S, Feroci F, Giani I, Tutino R, Cocorullo G, Gulotta G, Licari L, Salamone G, Sileri P, Saraceno F, La Torre F, Chirletti P, Coletta D, De Toma G, Mingoli A, Papandrea M, De Luca E, Sacco R, Sammarco G, Vescio G, Tonini V, Bianchini S, Cervellera M, Vaccari S, Cracco N, Barugola G, Bertocchi E, Rossini R, Ruffo G, Sartori A, Clemente N, De Luca M, De Luca A, Scaffidi G, Lorenzon L, Balducci G, Bocchetti T, Ferri M, Mercantini P, Pata F, Bauce S, Benevento A, Bottini C, Crapa PR, Rubbini M, Anania G, Carcoforo P, Cavallesco G, Feo C, Yamamoto T, Sivins A, Ancans G, Gerkis S, Lunis R, Pcolkins A, Venskutonis D, Bradulskis S, Dainius E, Subocius A, Vencius J, Zeromskas P, Eismontas V, Nutautiene V, Simcikas D, Tamosiunas A, Svagzdys S, Latkauskas T, Lizdenis P, Saladzinskas Z, Tamelis A, Dulskas A, Kuliavas J, Samalavicius NE, Poskus T, Jotautas V, Mikalauskas S, Poskus E, Strupas K, Zakaria AD, Lah NN, Wong M, Zain WZ, Zakaria Z, Mazlan L, Mohd Azman ZA, Sagap I, Psaila J, Andrejevic P, Cini C, Ellul S, Pace K, Ahallat M, Hamid M, Hrora A, Majbar MA, Raiss M, Westerduin E, Bemelman W, Buskens C, Tanis P, van der Sluis PC, Davids PH, Pronk A, Schiphorst AHW, Smakman N, Zimmerman D, Koeter T, Stijns J, van Loon YT, Vermaas M, de Graaf E, Doornebosch P, van Hagen P, van Ruler O, Toorenvliet B, Nonner J, van den Berg I, van Steensel L, Vles W, Melenhorst J, Orsini R, Visschers R, Hoff C, Blom R, Marsman H, Mulder I, Cense H, de Castro S, Demirkiran A, Hunfeld M, van Geloven A, de Groof J, Hendriks E, Leeuwenburg M, van Oorschot N, Wit F, Rupert C, Veldman P, Keijzers M, Konsten J, Den Boer F, Corver M, Boerma EG, Koolen L, Martens M, Van Wijck K, Ignjatovic D, Breuer R, Gurpreet B, Oresland T, Tetens Moe T, Nesbakken A, Flaaten Backe I, Wik TA, Radiya K, Dehli T, Gjessing P, Norderval S, Woll K, Anwer M, Qureshi MS, Qureshi AU, Billah M, Jawad MY, Raza A, Urooj N, Wang X, Li L, Jajtner D, Gasinski B, Kabiesz W, Walega P, Romaniszyn M, Zawadzki M, Czarnecki R, Obuszko Z, Rzaca M, Sitarska M, Silva P, Duarte A, Gonçalves D, Morais M, Rama N, Nobre J, Sales I, Costa Pereira J, Costa S, Costa Pereira C, Insua C, Romero I, Figueiredo N, Cunha J, Domingos H, Vieira P, Cunha M, Americano M, Amorim E, Rachadell J, Carvas JM, Armas I, Fernandes P, Pires C, Reis R, Martins R, Dos Santos M, Henriques P, Oliveira O, Duarte M, Ferreira L, Miranda J, Vilela N, Corte Real J, Carlos S, Frois Borges M, Moniz Pereira P, Simões J, Silva-Vaz P, Bettencourt V, Gouveia A, Perez H, Rainho R, Bintintan V, Ciuce C, Dindelegan G, Scurtu R, Seicean R, Cristian D, Burcos T, Grama F, Mandi DM, Richiteanu G, Miron A, Calu V, Enciu O, Nadragea M, Parvuletu R, Mogoanta SS, Crafciuc A, Paitici S, Negoi I, Beuran M, Ciubotaru C, Prodan A, Vartic M, Tomulescu V, Copaescu C, Yanishev A, Abelevich A, Kokobelyan A, Lebedeva M, Luzan R, Pozdnyakov A, Cherdancev D, Mahotin D, Nesytykh A, Samsonyuk V, Pravosudov I, Ivlev D, Karachun A, Lebedev K, Samsonov D, Aiupov R, Feoktistov D, Garipov M, Suleymanov N, Tarasov N, Rasulov A, Dzhumabaev H, Mamedli Z, Bedzhanyan A, Popov D, Sednev A, Klimenko A, Semenov A, Vasilyev S, Khazov A, Khanevich M, Khrykov G, Katorkin S, Andreev P, Chernov A, Davidova O, Zhuravlev A, Achkasov S, Shakhmatov D, Shelygin Y, Sushkov O, Vardanyan A, Ilkanich A, Barbashinov N, Darvin V, Onishchenko S, Voronin Y, Krivokapić Z, Barišić G, Dimitrijević I, Marković V, Sekulić A, Stanojevic G, Brankovic B, Nestorovic M, Pecic V, Petrovic D, Kostic I, Aleksic A, Dabic D, Maric B, Perunicic V, Radovanovic Z, Djuric M, Lukic D, Radovanovic D, Cuk V, Juloski J, Kenic M, Krdzic I, Ngu JC, Ng YY, Teo N, Korcek J, Lazorisak A, Rems M, Ramovš Trampuš Š, Tomazic A, Grosek J, Kosir J, Norcic G, Vigorita V, Caceres N, Casal E, Ruano A, Trostchansky I, Golda T, Galvez Saldaña A, Kreisler Moreno E, Lopez Dominguez J, Vila Tura M, Labarga F, Galvez P, Maderuelo V, Suero C, Bargallo J, Cayetano L, Lamas S, Silva MC, Bernal-Sprekelsen JC, Gómez R, Jareño S, Ríos A, Vercher D, García-González JM, Cervera-Aldama J, Ramos-Prada J, Santamaría-Olabarrieta M, Borda N, Enrriquez-Navascués JM, Saralegui Y, Calero-Lillo A, Aznar-Puig S, López-Lara MA, Muñoz-Collado S, Valverde-Sintas J, Menendez P, Leon C, Truan N, Baldonedo R, Fernández-Martínez D, Otero J, Solar-García L, Turrado-Rodriguez V, de Lacy Oliver F, Lacy Fortuny AM, Martin Perez B, Otero Piñeiro AM, Paredes J, Fernandez F, Ladra MJ, Paulos A, Prieto D, de Heredia JPB, Blanco Antona F, de Andrés Asenjo B, Ferreras García C, de Diego AR, de Laspra ECD, 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Dieguez Fernandez B, Gilsanz Martin C, Hernandez Garcia M, Rojo López JA, Gil López JM, González Zunzárren M, Martínez Alegre J, Zorrilla Matilla LP, Navarro-Sánchez A, Alcalá Serrano FJ, López-Fernández J, Montesdeoca Cabrera D, Alvarez-Gallego M, Guevara J, Pascual Miguelañez I, Rubio-Perez I, Gomez Ruiz M, Alonso Martín J, Cagigas Fernández C, Castillo Diego J, Pando JA, Maristany C, Muñoz-Duyos A, Rada-Palomino A, Vargas-Pierola H, Peña Ros E, Benavides Buleje JA, Muñoz Camarena JM, Parra Baños PA, Ramirez Faraco M, Arenal JJ, Citores MA, Marcos JL, Sánchez J, Tinoco C, García Flórez LJ, Arias Pacheco RD, Mínguez Ruiz G, Gutiérrez Corral N, Rodríguez Infante A, Carrillo López MJ, Carrasco Prats MM, Lage Laredo A, Martínez Manzano Á, Rodríguez García P, Segura-Sampedro JJ, Alonso-Hernández N, Fernandez Isart M, Gamundi Cuesta M, Ochogavia Segui A, Ibañez N, Abrisqueta J, Lujan J, Gómez Pérez R, Corrales Valero E, Monje Salazar C, Sanchiz Cardenas E, Soler Humanes R, Jimenez-Rodriguez RM, De la Portilla F, Diaz Pavon JM, Garcia Cabrera AM, Reyes Diaz ML, Espin E, Marinello F, Martí M, Sanchez JL, Vallribera F, Orts Mico FJ, Ortin Navarro M, Perez Climent M, Serra Diaz C, Millan M, Caro A, Escuder J, Espina B, Feliu F, Climent Aira A, Estévez Diz A, Moreno Asencio MT, Varela Mato A, Vázquez Bouzán R, Minaya-Bravo AM, Diez-Alonso MM, Villeta-Plaza R, Guadalajara H, Alías D, García Olmo D, Pastor C, Valverde I, Sanchez Romero A, Gardea A, Gil Santos M, Nimmersgern T, Serrano Paz P, Romero-Simó M, Blasco-Segura T, Caravaca-García I, Costa-Navarro D, Zarco-Pleguezuelos A, Sánchez-Guillén L, Flor-Lorente B, Frasson M, García-Granero Á, García-Granero E, Arencibia B, Alonso J, Febles G, Nogués EM, Roque C, Segelman J, Nygren J, Nestler G, Abraham-Nordling M, Egenvall M, Myrelid P, Jung B, Loftås P, Lydrup ML, Azahr N, Buchwald P, Mangell P, Syk I, Nikberg M, Carlander J, Chabok A, Smedh K, Tiselius C, Haapaniemi S, Benckert A, Adamina M, Freil-Lanter C, Gingert C, Müller P, Schäfli J, Regusci L, Brenna M, Fasolini F, Misteli H, Kirchhoff P, Oertli D, Hahnloser D, Clerc D, Hübner M, Ris F, Buchs NC, Chevallay M, Morel P, Schiltz B, Wang JY, Su WC, Huang CW, Ma CJ, Tsai HL, Bugra D, Agalar F, Baloglu H, Basoglu I, Okkabaz N, Binboga E, Biricik A, Celik A, Yavuz E, Canda AE, Agalar C, Fuzun M, Sokmen S, Terzi C, Isik A, Karip B, Bilgili AC, Leventoğlu S, Aytac B, Küçükdiler E, Yıldız A, Yuksel O, Sinan H, Hancerliogullari O, Kaymak S, Kozak O, Ozer MT, Sarici IS, Akca O, Kalayci MU, Kara Y, Agcaoglu O, Balik E, Bayram O, Özbalcı GS, Özkan BB, Karabacak U, Sungurtekin U, Ozgen U, Demirbas S, Öztürk E, Isik O, Yilmazlar T, Colak E, Karagul S, Kinas V, Fearnhead N, Lord I, Stewart P, Zammit M, Arnold S, Battersby NJ, Broadhurst J, Moran S, Seretis F, Shabbir J, Jones C, Kynaston J, Vimalachandran D, Blower E, McFaul C, McWhirter D, Pilkington J, Wilson T, Chowdhary M, Stubbs B, Abdalkoddus M, Lai C, Thavanesan N, Yao C, Agarwal T, Dindyal 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Mothe S, Rahman M, Curtis N, Allison A, Dalton R, Francis N, Ockrim J, Psaras G, Dudarovaska H, Marharint T, Mostovoy E, Voloshin S, Kolesnik O, Makhmudov D, Altinel Y, Iqbal A, Cunningham L, Go K, Tan S.

Abstract

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 < 0.001). After case mix adjustment in a multilevel model, only planned open (and not laparoscopic converted) surgery was associated with increased major complications in comparison to laparoscopic surgery (OR 1.64, 1.27-2.11, P < 0.001).

CONCLUSIONS:

Appropriate laparoscopic conversion should not be considered a treatment failure in modern practice. Conversion does not appear to place patients at increased risk of complications vs planned open surgery, supporting broadening of selection criteria for attempted laparoscopy in elective colonic resection.

KEYWORDS:

Colon cancer; gastrointestinal surgery; laparoscopic surgery; rectal cancer; surgery

PMID:
30255643
DOI:
10.1111/codi.14371

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