TPW 1.10 Laparoscopic Conversion to Open Colorectal Cancer (CRC) Resections: A Cohort Study

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ID: 324001
2026
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Abstract
Abstract Aims Laparoscopic-CRC-resection has been universally-adopted in-management of-CRC (75% NBOCA-2025). Rates-of-lap-open-conversion is documented <20 %. Aim of study is to assess-causes-of laparoscopic-open-conversions & postoperative-outcomes. Methods Cohort-study-carried out: Jan’2007-to-Jan’2026 at-single institution. Descriptive-demographics & postoperative-outcomes in-laparoscopic-open-conversions-CRC-resections. Laparoscopic & open CRC-resections were-controls. Results Lap-open (n=145) Laparoscopic (n=1086) Open (n=785) Kruskal-Wallis (p-value) ANOVA Age(yrs) 69.3±1.0 69.7±0.4 71.0±0.5 NS Sex(M:F) 96:49 581:505 432:353 <0.005 ASA(median) 2±0 2±0.5 2±0.5 NS BMI(kg/m2) 27.8±0.5 26.5±0.2 26.5±0.3 <0.01 Operation-time(mins) 234 8±7.9 189.6±2.8 147.5±2.5 <0.0001 Emergency-(CRC(n) 18 100 315 <0.0001 Complications (n) Leaks 6 36 36 NS Ileus 22 159 134 NS HAP 18 89 95 <0.05 Anaemia(Tx) 7 23 29 <0.05 SSI’s 24 66 75 <0.001 Collections 9 58 54 NS Sepsis 11 55 54 NS LN-harvest(median) 18±6.5 18±5.5 16±5 <0.0001 ITU(n) 42 174 241 <0.0001 LOS(days) 8±4 6±3.5 10±4.5 <0.0001 90 day Mortality (n) 5 51 63 <0.005 Survival-rates(%) 1styear 90.9 88.9 80.8 Logrankp< 0.005(uncensored) 5thyear 69.4 70.3 52.6 10thyear 56.2 51.8 39.1 15thyear 31.8 39.3 26.6 Conclusion Lap-open-conversion-rate-was 11.8%, longer-operative-times & hospital-stay than laparoscopic-CRC-resections, yet survival unaffected. Intra-abdominal-adhesions was most common cause for lap-open conversion. In this study causes of conversion can be classified into technical issues (adhesions 38.6%, fatty omentum 24.8%, difficult anatomy 12.4%). tumour-factors (bulky tumour 16.6%), patient factors (high BMI, male pelvis 10.3%, multiple operations, severe cardio-thoracic disease) & intra-operative issues (uncontrolled bleeding 4.8%, bowel perforations, anastomotic concerns 2.1%).
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Authors K Riaz, M A Gok, S Khan, M Bughio, R U Aris, U A Khan
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.294
URL
https://doi.org/10.1093/bjs/znag087.294
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