scholarly journals Does Percutaneous Achilles Tenotomy Yield Comparable Short-Term Outcomes to Combined Open Achilles Tenotomy with Posterior Capsulotomy in Pediatric Patients with Clubfoot?

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0015
Author(s):  
Marine Coste ◽  
Mikhail Tretiakov ◽  
Neil V. Shah ◽  
Daniel M. Zuchelli ◽  
Joanne C. Dekis ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Multivariate Regression ◽  
Pediatric Patients ◽  
Operative Time ◽  
Complication Rates ◽  
Congenital Clubfoot ◽  
Short Term ◽  
Achilles Tenotomy ◽  
Posterior Capsulotomy ◽  
Reoperation Rates

Category: Hindfoot, Midfoot/Forefoot, Congenital Introduction/Purpose: As the most common musculoskeletal congenital anomaly, clubfoot (congenital talipes equinovarus) represents a commonly-encountered entity for pediatric orthopaedic and foot/ankle surgeons. As we have observed a shift towards more conservative, cost-conscious approaches to management, this study sought to compare short-term (30-day) perioperative and postoperative outcomes (complications and reoperations) in clubfoot patients who underwent either percutaneous Achilles tenotomy (PT) or combined open Achilles tenotomy with posterior capsulotomy (COTC). Methods: The National Surgical Quality Improvement Program (NSQIP) Pediatric Database was queried for all congenital clubfoot patients. Among those, patients who underwent percutaneous Achilles tenotomy (PT; CPT: 27606) or open Achilles tenotomy with posterior capsulotomy (COTC; CPT: 28262) were stratified into two cohorts. Cohorts were 1:1 propensity score-matched for gender, race, congenital clubfoot diagnosis, and ASA score. Demographics, peri- and 30-day postoperative data were collected for each group and compared using appropriate parametric tests. A p-value of 0.05 or lower indicated statistical significance. A binary stepwise multivariate regression model was used to assess the effects of age, gender, race, ASA score, congenital clubfoot, and surgery type on total complication and reoperation rates. Results: 690 patients were included (PT, n=345; COTC, n=345). PT patients were younger than COTC patients (1.58 vs. 4.26 years; p<0.001). However, gender and race distributions were comparable. PT patients incurred shorter operation-to-discharge intervals (0.24 vs. 1.1 days), total anesthesia (71.8 vs. 191.2 mins) and operative time (34.4 vs. 129.3 minutes) (all p<0.001). PT and COTC patients had comparable rates of postoperative complications (0.00 vs. 0.87%; p=0.082). Complications experienced by COTC patients included pneumonia (0.29%) and surgical site (0.29%), and urinary tract infections (0.29%). Both cohorts also had similar reoperation rates (0.58 vs. 1.45%; p=0.253). Multivariate regression analysis revealed that age, female sex, race, congenital clubfoot diagnosis, and type of surgery were not significantly associated with any increase in odds of incurring postoperative complications or reoperations. Conclusion: Patients who underwent PT were younger than those who underwent a COTC. In addition, COTCs were significantly longer and led to a greater length of stay than those who underwent PT. However, there was no significant difference in short-term post-operative complication and reoperation rates. Lastly, surgery type and operative time were not significant predictors for higher complication rates. Therefore, despite lengthier hospital stay and operative time for PT, COTC and PT had comparable and low short-term complication rates and appeared to be safe procedures for treatment of congenital clubfoot in pediatric patients.

Total elbow arthroplasty cases involving orthopedic residents do not affect short-term postoperative complications

2021 ◽  
pp. 175857322110344
Author(s):  
Adam M Gordon ◽  
Azeem Tariq Malik
Keyword(s):  
Postoperative Complications ◽  
Propensity Score ◽  
Operative Time ◽  
Propensity Score Match ◽  
Total Elbow Arthroplasty ◽  
Adverse Event Rate ◽  
Complication Rates ◽  
Short Term ◽  
Resident Participation ◽  
Elbow Arthroplasty

Background Impact of resident participation on short-term postoperative outcomes after total elbow arthroplasty has not been studied. The aim was to investigate whether resident participation affects postoperative complication rates, operative time, and length of stay. Methods The American College of Surgeons National Surgical Quality Improvement Program registry was queried from 2006 to 2012 for patients undergoing total elbow arthroplasty. A 1:1 propensity score match was performed to match resident cases to attending-only cases. Comorbidities, surgical time, and short-term (30-day) postoperative complications were compared between groups. Multivariate Poisson regression was used to compare the rates of postoperative adverse events between groups. Results After propensity score match, 124 cases (50% with resident participation) were included. Adverse event rate after surgery was 18.5%. On multivariate analysis, there were no significant differences between attending-only cases and resident involved cases, with regards to short-term major complications, minor complications, or any complications (all p > 0.071). Total operative time was similar between cohorts (149.16 vs. 165.66 min; p = 0.157). No difference was observed in the length of hospital stay (2.95 vs. 2.6 days), p = 0.399. Discussion Resident participation during total elbow arthroplasty is not associated with increased risk for short-term medical or surgical postoperative complications or operative efficiency.

scholarly journals Contemporary Comparison of Short-Term Outcomes after Total Ankle Replacement and Ankle Arthrodesis

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0008
Author(s):  
Junho Ahn ◽  
Kshitij Manchanda ◽  
Stephen Wallace ◽  
Dane K. Wukich ◽  
George T. Liu ◽  
...  
Keyword(s):  
Multivariate Regression ◽  
Ankle Arthrodesis ◽  
Patient Data ◽  
Adverse Outcomes ◽  
Total Ankle Replacement ◽  
Complication Rates ◽  
Short Term ◽  
Acs Nsqip ◽  
Ankle Replacement ◽  
Acs Nsqip Database

Category: Ankle, Ankle Arthritis Introduction/Purpose: During the last twenty years, studies comparing total ankle replacement (TAR) and ankle arthrodesis (AA) appear to demonstrate lower complication rates with TAR than with AA. However, advances in implant technology and surgical techniques have dramatically reduced complication rates. As a result, studies comparing TAR and AA require more patients to detect differences in rare events. Despite this, few epidemiologic studies have been performed examining short-term outcomes after TAR and AA using a contemporary patient population. The purpose of the current study was to compare perioperative outcomes after TAR and AA using patient data from the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database between 2012 and 2017. Methods: We reviewed patient data from ACS-NSQIP database collected between 2012 and 2017 using Current Procedural Terminology (CPT) codes 27700 (TAR), 27702 (TAR), 29899 (AA) and 27870 (AA). Patients were then excluded if they were treated for fractures, infections, non-foot or ankle-related conditions or had revision procedures. Patients were also excluded if they were older than 90 years as ACS-NSQIP does not report age above 90 years. The study population included those treated in inpatient and outpatient settings. The main outcomes of interest were readmission and reoperation related to initial surgery, surgical site complications and hospital length of stay (LOS). Predictors of adverse outcomes were evaluated through multivariate regression of patient demographics, comorbidities and treatment characteristics. Results: Out of 1214 patients included in the study, 187 (15.4%) patients were treated with AA, and 1027 (84.6%) underwent TAR. Patients with AA were younger, had higher body-mass index, higher white blood cell count, more often had diabetes mellitus (DM) treated with insulin, received more dialysis treatment, had higher anesthesia risk classification and were treated in the outpatient setting more often than patients with TAR. Among outcomes, AA patients had longer hospital LOS, more deep surgical site infections and more reoperations than TAR patients. Post-operative readmissions were not significant but were higher in AA patients (2.7% vs. 0.9%, p=0.101). Combining these adverse outcomes, multivariate regression revealed that higher anesthesia risk category (p=0.0007), DM (p=0.029) and AA (p=0.049) had positive correlations with adverse outcomes. Conclusion: Ankle arthrodesis appears to be independently associated with perioperative complications compared to TAR, consistent with previous reports. Although complications were rare, patients with DM and higher anesthesia risk seem to be important factors to consider. Interestingly, patients with DM had fewer adverse outcomes with TAR than AA (3.8% vs. 7.4%). The difference was even greater in DM patients treated with insulin (4.3% vs. 13.3%) although only 38 patients had DM controlled with insulin in the cohort. Further studies are needed to identify patient populations at risk of complications, specifically those with DM.

802 PERIOPERATIVE AND SHORT-TERM OUTCOMES FOR PRIMARY ANTIREFLUX SURGERY: FUNDOPLICATION VS. RNY RECONSTRUCTION

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Deepika Razia ◽  
Deepika Razia ◽  
Sumeet K Mittal
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Antireflux Surgery ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Perioperative Outcomes ◽  
Short Term ◽  
Perioperative Morbidity ◽  
Conversion To Open Surgery ◽  
Time Length

Abstract   Laparoscopic fundoplication is the gold standard for treatment of gastroesophageal reflux disease (GERD); however, RNY reconstruction may be an alternative option in patients with complex pathophysiology and other risk factors. This study aimed to compare perioperative and short-term outcomes between primary fundoplication and RNY reconstruction. Methods After IRB approval, a prospectively maintained esophageal surgery database was retrospectively reviewed to identify patients who underwent primary fundoplication or RNY reconstruction from September 2016 to July 2020. We retrieved perioperative outcomes (operative time, length of hospital stay, intraoperative and postoperative complications) along with GERD-Health-Related Quality of Life (HRQL) scores at annual follow-up. Results During the study period, 226 patients underwent surgery (fundoplication: 210; RNY: 16). The most common indication for RNY was severe esophageal dysmotility or morbid obesity. There was only one conversion to open surgery due to adhesions (fundoplication group). The operative time, length of hospital stay, and ICU stay were significantly lower in the fundoplication group. Rates of intraoperative (fundoplication: 3% vs RNY: 0) and postoperative complications (Clavien-Dindo ≥II) (fundoplication: 3% vs RNY: 6%) were not significantly different between groups. Both groups had a significant and similar improvement of GERD-HRQL scores 1 year after surgery (Table 1). Conclusion Primary antireflux surgery is associated with low perioperative morbidity and excellent short-term outcomes. RNY reconstruction and fundoplication have similar outcomes. More liberal use of RNY reconstruction as the primary antireflux surgery in patients at high risk of failure with fundoplication should be explored.

Trunk Fat Volume Can Be a Predictor of Short-Term Surgical Outcomes After Gastrectomy: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Shinichiro Shiomi ◽  
Tetsuro Toriumi ◽  
Koichi Yagi ◽  
Raito Asaoka ◽  
Yasuhiro Okumura ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Postoperative Complications ◽  
Lymph Nodes ◽  
Visceral Fat ◽  
Surgical Outcomes ◽  
Operative Time ◽  
Proximal Gastrectomy ◽  
Short Term ◽  
Visceral Fat Area ◽  
Fat Volume

Abstract Background Obesity can affect postoperative outcomes of gastrectomy. Visceral fat area is superior to body mass index in predicting postoperative complications. However, visceral fat area measurement is time-consuming and is not optimum for clinical use. Meanwhile, trunk fat volume (TFV) can be easily measured via bioelectrical impedance analysis. Hence, this current study aimed to determine the association of trunk fat volume in predicting the occurrence of complications after gastrectomy. Methods We retrospectively reviewed patients who underwent curative gastrectomy for gastric cancer between November 2016 and November 2019. The trunk fat volume-to-the ideal amount (%TFV) ratio was obtained using InBody 770 before surgery. The patients were classified into the obese and nonobese groups according to %TFV (TFV-H group, ≥ 150 %; TFV-L group, < 150 %) and body mass index (BMI-H group, ≥ 25 kg/m2; BMI-L group, < 25 kg/m2). We compared the short-term postoperative outcomes (e.g., operative time, blood loss volume, number of resected lymph nodes, and duration of hospital stay) between the obese and nonobese patients. Risk factors for complications were assessed using logistic regression analysis. Results In total, 232 patients were included in this study. The TFV-H and BMI-H groups had a significantly longer operative time than the TFV-L (p = 0.022) and BMI-L groups (p = 0.006). Moreover, the TFV-H group had a significantly higher complication rate (p = 0.004) and a lower number of resected lymph nodes (p < 0.001) than the TFV-L group. In univariate analysis, %TFV ≥ 150, total or proximal gastrectomy, and open gastrectomy were found to be potentially associated with higher complication rates with p values < 0.1. Meanwhile, multivariate analysis revealed that %TFV ≥ 150 (OR: 2.73; 95%CI: 1.37–5.46; p = 0.005) and total or proximal gastrectomy (OR: 3.57; 95%CI: 1.79–7.12; p < 0.001) were independently correlated with postoperative morbidity. Conclusions %TFV independently affected postoperative complications. Hence, it may be a useful parameter for the evaluation of obesity and a predictor of short-term surgical outcomes after gastrectomy.

Long-term Economic Impact of Coiling vs Clipping for Unruptured Intracranial Aneurysms

Neurosurgery ◽  
2013 ◽  
Vol 72 (6) ◽  
pp. 1000-1013 ◽  
Author(s):  
Shivanand P. Lad ◽  
Ranjith Babu ◽  
Michael S. Rhee ◽  
Robbi L. Franklin ◽  
Beatrice Ugiliweneza ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Intracranial Aneurysms ◽  
The United States ◽  
Endovascular Coiling ◽  
Complication Rates ◽  
Surgical Clipping ◽  
Unruptured Intracranial Aneurysms ◽  
Reoperation Rates

Abstract BACKGROUND: Treatment of unruptured intracranial aneurysms (UIAs) involves endovascular coiling or aneurysm clipping. While many studies have compared these treatment modalities with respect to various clinical outcomes, few studies have investigated the economic costs associated with each procedure. OBJECTIVE: To determine the reoperation rate, postoperative complications, and inpatient and outpatient costs associated with surgical or endovascular treatment of patients with UIAs in the United States. METHODS: We utilized the MarketScan database to examine patients who underwent surgical clipping or endovascular coiling procedures for UIAs from 2000 to 2009, comparing reoperation rates, complications, and angiogram and healthcare resource use. Propensity score matching techniques were used to match patients. RESULTS: We identified 4,504 patients with surgically treated UIAs, with propensity score matching of 3,436 patients. Reoperation rates were significantly lower in the clipping group compared to the coiling group at 1- (P &lt; .001), 2- (P &lt; .001), and 5 years (P &lt; .001) following the procedure. However, postoperative complications (immediate, 30 and 90 days) were significantly higher in those undergoing surgical clipping. Although hospital length of stay and costs were higher in the clipping group for the index procedure, the number of postoperative angiograms and outpatient services used at 1, 2, and 5 years were significantly higher in the coiling group. CONCLUSION: Though surgical clipping resulted in lower reoperation rates, it was associated with higher complication rates and initial costs. However, overall costs at 2 and 5 years were similar to endovascular coiling due to the significantly higher number of follow-up angiograms and outpatient costs in these patients.

scholarly journals Long Time from Diagnosis to Surgery May Increase Postoperative Complication Rates in Elective CD Intestinal Resections: An Observational Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Paulo Gustavo Kotze ◽  
Daniela Oliveira Magro ◽  
Carlos Augusto Real Martinez ◽  
Antonino Spinelli ◽  
Takayuki Yamamoto ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Postoperative Complications ◽  
Observational Study ◽  
Surgical Site Infections ◽  
Anastomotic Dehiscence ◽  
Binary Logistic Regression Analysis ◽  
Significant Variable ◽  
Complication Rates ◽  
Short Term ◽  
Time To Surgery

Background. There is lack of data analyzing short-term postoperative complications and time from diagnosis to surgery in Crohn’s disease (CD). Aim. To compare complication rates after elective abdominal operations in CD patients with different durations of disease. Methods. Retrospective observational study with CD patients who submitted to elective intestinal resections. Patients were allocated in 2 groups according to time to surgery (TS) in less or more than 5 years. Short-term postoperative complications were analyzed and compared between the 2 groups, and binary logistic regression analysis was performed to check for significant variables. Results. 123 patients were finally included, 77 with TS > 5 years (62.6%) and 46 with TS < 5 years (37.4%). Patients with TS > 5 years had higher rates of overall surgical complications (p=0.011), reoperations (p=0.003), surgical site infections (p=0.014), anastomotic dehiscence (p=0.021), abdominal abscesses (p=0.021), and overall medical complications (p=0.019). On logistic regression, the single significant variable was the confection of stomas (OR: 3.203; 95% CI: 1.011–10.151; p=0.048). Conclusions. Patients with longer time to surgery showed a significant increase in overall medical and surgical postoperative early complications after elective intestinal resections.

scholarly journals Radical retropubic prostatectomy for prostate carcinoma: First results of the Clinic of urology in Skopje

2005 ◽  
Vol 52 (4) ◽  
pp. 37-40
Author(s):  
S. Stavridis ◽  
V. Georgiev ◽  
Z. Popov ◽  
M. Penev ◽  
Lj. Lekovski ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Prostate Carcinoma ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Distant Metastases ◽  
Radical Retropubic Prostatectomy ◽  
Complication Rates ◽  
Retropubic Prostatectomy ◽  
Golden Standard ◽  
First Results

Objectives: The aim of this retrospective study is to present our experience and results in the management of prostate carcinoma, with radical retropubic prostatectomy, for a period of seven years. Material and methods: From December 1997 to April 2005, 61 radical retropubic prostatectomies for prostate carcinoma were performed at the Clinic of Urology in Skopje. Mean age of the treated patients was 66.4 years. Mean serum PSA level was 32.75 ng/ml. None of the patients had distant or bone metastases. Mean operative time was 160 minutes and from 2 to 4 units of blood were transfused intra and postoperatively. Mean follow up time was 39 months. Results: In all of 61 patients, the RRP was performed for adenocarcinoma of the prostate. The pathological findings postoperatively showed the following pTNM grade: pT2a in 8, pT2b in 10, pT3a in 10, pT3b in 27and pT4 in 6 patients. Positive lymph nodes were found in 14 cases. Intraoperative complications occurred in 6 patients. Early postoperative complications were seen in 12 patients. Urine leakage was seen in 2 patients, incontinence (day and night) in 8 and pulmonary embolia in 2 patients. Late postoperative complications occurred in 11 patients. Stenosis of the vesico-urethral anasthomosis was seen in 3 patients and incontinence (during the night only) in 8 patients. The rate of potency was not evaluated but in the last 30 cases we insisted on preservation of the neurovascular bundles in the cases that it was possible. Conclusion: Radical retropubic prostatectomy is the method of choice and the golden standard for treatment of organ confined prostate carcinoma in patients with long life expectancy, no neither local nor distant metastases and good overall status. With this technique complication rates are minimal, the cure rate is very big and the patients have high quality of life. The experience of the surgeon is very important since the learning curve is crucial for diminishing operative time, postoperative complications and blood transfusions.

scholarly journals Short-Term Efficacy of Laparoscopic Treatment for Colorectal Cancer in Patients with Schistosomiasis Japonica

2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Zhu Yi ◽  
Jiang Hong-Gang ◽  
Chen Zhi-Heng ◽  
Lu Bo-Hao
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Colorectal Surgery ◽  
Operative Time ◽  
Laparoscopic Colorectal Surgery ◽  
Schistosomiasis Japonica ◽  
Laparoscopic Treatment ◽  
Short Term ◽  
The Mean ◽  
Postoperative Feeding

Introduction. Schistosomiasis is associated with numerous complications such as thrombocytopenia, liver cirrhosis, portal hypertension, and colitis. To the best of our knowledge, the feasibility and outcomes of laparoscopic colorectal surgery in patients with schistosomiasis have not yet been studied.Methods. In this study, the data of 280 patients with colorectal carcinoma along with schistosomiasis japonica infection who underwent laparoscopic or open colorectal surgery were retrospectively analyzed. Preoperative data, operative data, pathological outcomes, postoperative complications, and recovery were compared between patients in the laparoscopic (LAC) and open (OC) groups.Results. There were no significant differences in the preoperative data between the groups. However, fewer postoperative complications, especially severe hypoproteinemia, early postoperative feeding, and shorter postoperative hospital stay, were observed in patients in the LAC group (P<0.001). The mean operative time was higher in the LAC group (180 min versus 158 min;P<0.001), while the mean blood loss was similar (95 mL versus 108 mL;P=0.196) between groups. The mean number of lymph nodes harvested was also similar in both groups (15 versus 16;P=0.133).Conclusion. Laparoscopic surgery for colorectal cancer is safe in patients with schistosomiasis japonica and has better short-term outcomes than open surgery.

Short-Term Perioperative Outcomes and Complications in Chronic Immunosuppressant Users following Total Hip Arthroplasty

2017 ◽  
Vol 01 (03) ◽  
pp. 152-157 ◽  
Author(s):  
Gannon Curtis ◽  
Morad Chughtai ◽  
Anton Khlopas ◽  
Jaiben George ◽  
Nipun Sodhi ◽  
...  
Keyword(s):  
Septic Shock ◽  
Operative Time ◽  
Adverse Outcomes ◽  
Perioperative Outcomes ◽  
Control Group ◽  
Complication Rates ◽  
Short Term ◽  
Improvement Program ◽  
Total Hip ◽  
Lengths Of Stay

AbstractAs the rate of total hip arthroplasties (THA) being performed continues to increase, orthopaedic surgeons are likely to operate on patients who use systemic immunosuppressants for a variety of ailments. It may be necessary to continue these medications perioperatively, and it has been reported that they may affect post-operative outcomes. The authors proposed the following questions: (1) Are perioperative outcomes (i.e., operative time, lengths-of-stay, and discharge disposition) affected by chronic immunosuppressant use during THA, and (2) does chronic immunosuppressant use increase the rate of complications within 30-days of THA? The American College of Surgeons National Surgical Quality Improvement Program database was used to identify all THAs from 2008 to 2014. Only osteoarthritis diagnoses were included, and any emergency or concurrent surgeries were excluded. The authors identified 64,796 cases that met the inclusion/exclusion criteria. Prior to surgery, 1,900 patients used chronic immunosuppressants, while 62,896 patients did not use immunosuppressants. Lengths-of-stay, operative time, discharge destination, and 30-day complication rates were the measured perioperative outcomes. To determine significant outcome differences between cohorts, univariate analysis was applied. Next, multivariate regression analysis helped determine if immunosuppressant use independently increased the risk for the measured outcomes and complications. Chronic immunosuppressant users were at higher risk of certain adverse perioperative outcomes and short-term complications. Compared with the control group, immunosuppressant users were more likely to be discharged to a non-home facility (odds ratio [OR]: 1.16; 95% confidence interval [CI]: 1.03–1.31). These patients also had greater rates of septic shock (OR: 2.88; 95% CI: 1.08–7.67) and 30-day readmission (OR: 1.37; 95% CI: 1.10–1.70). Chronic immunosuppressant use leads to higher rates of complications and adverse outcomes following THA. Adverse outcomes related to immunosuppressant use included higher rates of non-home discharge. Complications related to immunosuppressant use included septic shock and 30-day readmission.

Impact of Timing of Conversion to Open Surgery on Short-Term and Oncologic Outcomes in Patients Undergoing Minimally Invasive Surgery for Colorectal Cancer

2017 ◽  
Vol 83 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Ik Yong Kim ◽  
Bo Ra Kim ◽  
Young Wan Kim
Keyword(s):  
Colorectal Cancer ◽  
Minimally Invasive Surgery ◽  
Postoperative Complications ◽  
Open Surgery ◽  
Operative Time ◽  
Oncologic Outcomes ◽  
Short Term ◽  
Open Conversion ◽  
Soft Diet ◽  
History Of

To evaluate the influence of timing of open conversion on short-term and oncologic outcomes after minimally invasive surgery for colorectal cancer. Six hundred forty-six consecutive patients were enrolled. All patients converted to open surgery were classified into early (n = 10) or late (n = 67) groups based on conversion timing using a 60-minute cutoff. A comparison of early conversion and nonconverted groups showed that history of prior abdominal surgery and pT4 tumor was more common in the early conversion group. Mean operative time was longer in the early conversion group. Rates of 30-day postoperative complications (30% vs 27%), time to soft diet (5 days vs 5 days), and hospital stay (12 days vs 12 days) were not different. A comparison of the late and nonconverted groups showed that history of prior abdominal surgery was more common in the late conversion group. Mean operative time was longer in the late conversion. Rates of 30-day postoperative complications (42% vs 27%), Clavien–Dindo score ≥3 (22% vs 11%), intensive care unit care (31% vs 15%), and transfusion (37% vs 21%) were significantly higher in the late conversion group. Time to soft diet (6 days vs 5 days) and hospital stay (15 days vs 12 days, P = 0.037) were longer in the late conversion group. Cancer-specific and recurrence-free survival rates did not differ among the early, late conversion, and nonconverted groups. Decisions about open conversion need be made within 60 minutes of the beginning of surgery as early conversion does not worsen short-term and oncologic outcomes.

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