• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Factors leading to a higher conversion rate after laparoscopic rectal cancer surgery and its impact on morbidity and mortality

Factors leading to a higher conversion rate after laparoscopic rectal cancer surgery and its impact on morbidity and mortality

Mhgm van der Pas, MD, Gsa Abis, MD, Es de Lange, PhD, Ma Cuesta, PhD, Hj Bonjer, PhD, Color Ii Studygroup. Department of Surgery, Maastricht university Medical Center, the Netherlands andDepartment of Surgery, VU University Medical Center Amsterdam, The Netherlands.

Background: Since the first reports on laparoscopic total mesorectal excision for rectal cancer, different factors influencing conversion rate have been suggested. Incidence, predictive factors, mortality and morbidity of conversion in the COlorectal cancer Laparoscopic or Open Resection COLOR II) trial are presented.
Methods and procedures: Between January 20, 2004 and May 4, 2010, 1044 patients were enrolled in the COLOR II trial, comparing laparoscopic and open surgery for rectal cancer. Six hundred and ninety-nine patients were allocated to laparoscopic surgery. A total of 693 patients actual received laparoscopic surgery. Analysis was by treatment received. One hundred and fourteen (16%) of 693 patients were converted to open surgery. Predictive factors were studied using multivariate analyses. Morbidity and mortality between patients needing conversion and patients who had planned open or laparoscopic surgery were compared.
Results: Factors which were correlated with intraoperative conversion are: age above 65 years (OR 1.9; 95% CI 1.2-3.0: p=0.003), BMI>25 (OR 2.7; 95% CI 1.7-4.3: p<0.001) and tumor location 5-10 cm from the anal verge (OR 2.1; 95% CI 1.2-3.7: p=0.020) and 10-15 cm (OR 2.0; 95% CI 1.1-3.5: p=0.008) compared to tumors located < 5 cm from the anal verge. Gender was not significantly related to the need for conversion (p=0.143). Conversion was associated with more blood loss (p<0.001) and prolonged operating times (p=0.028) when compared to the non-converted laparoscopic group. No significant difference in hospital stay was shown between laparoscopic and converted patients (p=0.063). Patients needing conversion had more postoperative complications compared to laparoscopic surgery and open surgery (p= 0.041 and p=0.042 respectively). Mortality was comparable in both groups.
Conclusions: Patients over 65 years of age with a BMI >25 and a tumor located between 5-15 cm from the anal verge are more likely to need intraoperative conversion reducing the benefits of laparoscopic surgery. After conversion, patients show a significantly higher postoperative complication rate.

Colorectal cancer Laparoscopic or Open Resection II (COLOR II) study group: André D’Hoore, Dan Birch, Chris DeGara, Jaap Bonjer, Chris Jamieson, Poornoroozy Peiman, Karl Juul Jensen, Orhan Bulut, Per Jess, Jacob Rosenberg, Thomas Harvald, Henrik Ovesen, Eskilde Lundhus, Igors Iesalnieks and Ayman Agha, Christina Jaeger, Martin Kreis, Michael Kasparek, Alois Fuerst, Gudrun Liebig-Hoerl, Seon Hahn Kim, Donald van der Peet, Miguel Cuesta, Martijn van der Pas, Mark Buunen, Peter Neijenhuis, Peter Paul Coene, Edwin van der Harst, Yvonne van Riet, Willem Bemelman, Michael Gerhards, Hubert Prins, Eduardo Targarona, Carmen Balague, Carmen Martinez, Juan Franco Osorio, García Molina, Antonio Lacy, Salvadora Delgado, Juan Lujan, Graciela Valero, Alfredo Alonso-Poza, Manual Losadar, Salvador Argudo, Hospital del Sureste de Madrid, Zoltan Lackberg, Stefan Skullman,  Goran Kurlberg, Eva Haglind, Ulf Kressner, Peter Matthiessen.

141

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals