Abstract: 【Abstract】 Objective To evaluate the factors of conversion to open surgery in laparoscopic colorectal surgery, and choice the correct time turned to laparotomy during 13 years. Methods 1682 laparoscopic colorectal surgeries were included in the study. The reasons of conversion to open surgery from July 1999 to June 2012 were analyzed retrospectively. Results Among 1682 cases underwent laparoscopic colorectal surgeries, 1585 were performed successfully, 97 were turned to conversion to open surgery. The conversion rate was 5.77 %. The most common initiative reason was involvement of surrounding viscera or malignant tumor infiltration (53.8%, 49/91). The most common segment was sigmoid colon (24/91, 26.4%) and rectum (19/91, 20.9%). There were no statistical differences of operation time, intra-operative blood loss, recovery time of bowel movement, post-operative stay, lymph node yield and incidence of post-operative complications between the two groups. Conclusion In laparoscopic surgery for colorectal cancer, correct handling of indications for conversions to open surgery is an important step to ensure the safety of the patients.

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

摘要： 摘要 目的 总结13年腹腔镜结直肠癌手术中转开腹的相关因素和时机。方法 对1999年7月到2012年6月我院进行的1682例腹腔镜结直肠手术的临床资料进行回顾性分析,探讨其中转开腹的原因。结果 1585例顺利完成腹腔镜手术,中转开腹97例,中转开腹率5.77%,最常见的主要中转原因是周围脏器受累高达53.8%(49/91),最常见的发生部位是乙状结肠(24/91,26.4%)和直肠(19/91,20.9%)。腹腔镜组和中转开腹组在手术时间、术中出血量、肠功能恢复情况、术后平均住院日、切除淋巴结个数及术后并发症发生率等方面无统计学差异。结论 在腹腔镜结直肠癌手术中,必须熟练掌握中转开腹的指征,才能保证手术的顺利完成。

关键词: 腹腔镜, 结直肠癌, 中转开腹