Abstract: 【Abstract】 Objective〓To evaluate the risk factors for conversion of laparoscopic to open surgery for colorectal cancer. Methods〓A retrospective analysis of our hospital from January 2002 to January 2012, a total of 813 cases of laparoscopic colorectal resection were retrospectively analyzed, including 68 patients converted to open surgery. The clinical baseline data, perioperative data, short-term clinical efficacy were compared between laparoscopic and conversion groups. Results〓The rate of conversion to open surgery was 8.3%(68 patients). Stage IV, T4 stage, tumor length >5 cm, surgical procedures, abdominal surgery history were significantly associated with the risk of conversion to open surgery. In terms of surgery-related data,although laparoscopic group had slightly longer operation time, conversion group had more blood loss during surgery(262.4 ml vs 104.3 ml, P <0.001) and blood transfusion (126.8 ml vs 17.8 ml, P<0.001). In terms of short-term clinical efficacy, the time to soft diet (3.82 vs 4.63 day, P<0.001), time to flatus (2.95 vs 3.41 day,P<0.001), time to ambulation (2.37 vs 3.14 day, P<0.001), and length of hospital stay (18.9 vs 22.4 day, P<0.001) had significant differences between the two groups. Conclusion〓T4 tumor stage, stage IV, abdominal surgery history, tumor size > 5 cm and surgical procedures are independent factors for conversion to open surgery.

Key words: Laparoscopy, Conversion to open surgery, Colorectal cancer

摘要： 【摘要】〓目的〓评估腹腔镜结直肠癌切除术手术相关中转开腹的危险因素。方法〓回顾性分析我院自2002年1月至2012年1月共813例腹腔镜结直肠切除术的病例资料,其中中转开腹的患者68例。比较中转开腹和腹腔镜组两组患者的一般临床资料、围手术期数据、短期临床疗效。结果〓手术中转开腹率为8.3%,IV期疾病、T4期肿瘤、肿瘤长度>5 cm,手术术式、腹部手术史均为中转开腹的独立危险因素。在手术相关数据方面,虽然手术时间未开腹组较开腹组略长,但开腹组在术中失血量(262.4 mL vs. 104.3 mL,P<0.001)和输血量(126.8 ml VS 17.8 mL P<0.001)上,均明显高于未开腹组。在术后短期临床疗效方面,两组在恢复软食时间(3.82 vs 4.63天,P<0.001),肛门开始排气时间(2.95 vs. 3.41天,P<0.001),下床活动时间(2.37 vs. 3.14天,P<0.001),住院时间(18.9 vs. 22.4天,P<0.001)上均具有明显的统计学差异。结论〓T4期肿瘤、IV期疾病分期、腹部手术史、肿瘤直径大于5 cm和手术术式都是影响术中中转开腹的独立因素。

关键词: 腹腔镜手术, 手术相关中转开腹, 结直肠癌