Conversion index in the laparoscopic colorectal resections

[摘要] Introduction: Little diffusion of the use of laparoscoipic colon and rectal resections compared to that of other surgical procedures such as cholecystectomy, funduplicature and cardiomyotomy is basically due to three disadvantages: increase of direct costs, technical complexity, and existing doubts on the oncologic criteria to be respected for in the specific case of colorectal cancer. The technical complexity of this surgery implies much training and high conversion index when comparing it with other surgical procedures. The National Center of Endoscopic Surgery began to perform laparoscopic colon and rectal surgery in 1995.Objective: To analyze the factors that relate with the conversion index in the laparoscopic colon and rectal resections.Methods:Analysis of 660 colon and rectal resections performed at the National Center of Minimal Access Surgery from 1996 through 2012. Performed operations, surgical time, morbidity, conversion index and causes were all presented in this paper.Results: The conversion index decreased from 16% in the first 50 surgeries to 4% in the last 50. Global morbidity rate was 16% but increased to 33.3% in cases converted to open surgery as it happened in mortality (2% to 5.4%).Conclusions: The decision on conversion to open surgery must be early taken with a view to decreasing morbidity rates. Adequate selection of patients and experience of the surgical team are inversely proportionate to the conversion index. 

[学科分类] 外科医学

[关键词] laparoscopic resections;conversion index;morbidity.