Is there a role for a strict incision length criterion for determining conversions during laparoscopic colorectal resection?

Anaeze C. Offodile, Emre Balik, Aviad Hoffman, Victor Moon, Raymond Baxter, Michael Grieco, Dovid Moradi, Ik Yong Kim, Abu Nasar, Vesna Cekic, Daniel L. Feingold, Tracey D. Arnell, Emina Huang, Richard L. Whelan

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose Theres no consensus about what defines a conversion for laparoscopic-assisted colorectal resection (LACR). This studys goal was to assess the utility of a strict incision length (IL) definition of conversion (incision > 7 cm) and compare it with results obtained when the surgeon determined (SD) if a LACR had been successfully completed. Methods. The demographic and perioperative data for 580 elective LACRs were reviewed. The short-term outcomes for each conversion definition were determined and compared. Results. Conversion rates were 22% using the IL definition and 16% via the SD method. Both methods detected significant differences between completed and converted groups regarding the following: incision size, hospital stay, time to flatus, bowel movement, and regular diet as well as rate of wound infection and ileus. The IL method alone detected significant differences in the rate of pulmonary complications and BMI between the completed and converted groups. Conclusions. The 2 methods yielded similar results for most parameters. The IL method better separated the patients in regard to 2 parameters. This method is objective and easy to apply; however, it may discriminate against obese patients whose extraction incisions are often longer. A conversion definition that considers BMI and IL is needed.

Original languageEnglish (US)
Pages (from-to)120-126
Number of pages7
JournalSurgical Innovation
Volume17
Issue number2
DOIs
StatePublished - Jun 2010
Externally publishedYes

Keywords

  • Conversion
  • Incision length
  • Laparoscopic colorectal resection
  • Laparoscopic-assisted colectomy
  • Minimally invasive colorectal resection

ASJC Scopus subject areas

  • Surgery

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