Conversion in laparoscopic gastric cancer surgery a highlight on the abdominal access

Abstract

Aim: The aim of this study was to compare the data of patients who underwent gastric cancer surgery as laparoscopically completed
and converted to open surgery and draw attention to complications arising from trocar entry.
Materials and Methods: This study included 211 patients who underwent laparoscopic gastric cancer surgery. Patients were divided
in to two groups as laparoscopically completed and converted to open surgery. Demographics parameters and perioperative data
were retrospectively analyzed.
Results: The median age of the study group was 62 (19-91) years and 68.2% were males. Conversion occured in 16 patients (7.5%).
The reasons for conversion were locally advanced tumor (n=6), complications due to trocar insertion (n=4), technical difficulty
in performing esophagojejunostomy anastomosis (n=4), leakage in esophagojejunostomy anastomosis (n=1), and persistent
bradycardia (n=1). Intraoperative blood loss was higher and time to oral intake was longer in the conversion group. No significant
difference was found in terms of demographic parameters, operative time, length of hospital stays, the rate of postoperative
complications, reoperation, 30-day mortality.
Conclusion: Complications due to trocar entry is an unpredictable and preventable conversion reason in laparoscopic gastric cancer
surgery. Thin patients are riskier for complications during abdominal access. Abdominal access should be performed with an open
technique in thin patients