Is conversion from laparoscopic to open surgery in colorectal cancer predictable in the preoperative period?

INTRODUCTION: This study aimed to evaluate the risk factors associated with conversion from laparoscopic colorectal resection to open surgery and investigate whether the possibility of such a conversion requirement can be predicted in the preoperative period.
METHODS: Between 2014 and 2018, following the diagnosis of colorectal cancer, 467 patients underwent laparoscopic resection in our general surgery clinic, of whom 126 were included in this study based on the availability of the parameters of conversion of laparoscopic rectal resection to open surgery (CLRROS) and the Cleveland Clinic Foundation colorectal laparoscopic conversion (CCF-CLC) scores.
RESULTS: Of the 126 patients included in this study, 97 (76%) underwent laparoscopic resection (classified as Group 1), and 29 (24%) cases were converted to open surgery (classified as Group 2). The mean age±standard deviation (SD) was 58±13 and 62±15 years for Groups 1 and 2, respectively. The CLRROS and CCF-CLC scores were 8±8 and 16.6±9.2, respectively in Group 1, and 17±10 and 17.7±10.5, respectively in Group 2. The receiver operating characteristic analysis results were 0.769 (95% CI: 0.666–0.871, p=0.000) and 0.508 (95% CI: 0.382–0.634, p=0.896) for the CLRROS and CCF-CLC scores, respectively.
DISCUSSION AND CONCLUSION: To predict conversion from laparoscopy to open surgery, it was concluded that the CLRROS and CCF-CLC scores could help in selecting cases suitable for laparoscopy and inform patients about the expected postoperative outcomes, as well as minimizing postoperative disadvantages.