Impact of conversion during laparoscopic gastrectomy on outcomes of patients with gastric cancer.

PURPOSE: This study reports the impact of conversion from laparoscopic gastrectomy to open gastrectomy on the short- and long-term outcomes of patients with gastric cancer.

METHODS: Retrospective analysis of clinical and follow-up data of 236 patients with gastric cancer who underwent laparoscopic gastrectomy between January 2010 and October 2016 was performed. Patients were divided into the conversion and complete laparoscopy groups based on whether conversion to open gastrectomy occurred during surgery or not. Short- and long-term outcomes were compared between these two groups.

RESULTS: The conversion rate was 10.1% (24/236). The reported reasons for conversion were adhesion, obesity, uncontrollable bleeding, and T4 stage tumor during surgery. Compared to the complete laparoscopy group, patients in the conversion group had longer operation time (p=0.028), greater intraoperative blood loss (p=0.011), and longer hospital stay (p=0.030). No statistically significant differences were found in the incidence and severity of complications within postoperative 30 days between the two groups. Obesity, tumor site in the upper gastric region, and surgery performed between 2010 and 2012 were independent predictors for conversion. Additionally, no statistical differences in the pathological findings and long-term outcomes were found between the two groups.

CONCLUSION: Except from increased operation time, intraoperative blood loss, and length of hospital stay, conversion from laparoscopic gastrectomy to open gastrectomy had no impact on postoperative complications and long-term outcomes of patients with gastric cancer.