title: Is there a role for a strict incision length criterion for determining conversions during laparoscopic colorectal resection?
abstract: OBJECTIVE
  There's no consensus about what defines a conversion for laparoscopic-assisted colorectal resection (LACR). This study's goal was to assess the utility of a strict incision length (IL) definition of conversion (incision > 7 cm) and compare it with results obtained when the surgeon determined (SD) if a LACR had been successfully completed.
  
  
  METHODS
  The demographic and perioperative data for 580 elective LACRs were reviewed. The short-term outcomes for each conversion definition were determined and compared.
  
  
  RESULTS
  Conversion rates were 22% using the IL definition and 16% via the SD method. Both methods detected significant differences between completed and converted groups regarding the following: incision size, hospital stay, time to flatus, bowel movement, and regular diet as well as rate of wound infection and ileus. The IL method alone detected significant differences in the rate of pulmonary complications and BMI between the completed and converted groups.
  
  
  CONCLUSIONS
  The 2 methods yielded similar results for most parameters. The IL method better separated the patients in regard to 2 parameters. This method is objective and easy to apply; however, it may discriminate against obese patients whose extraction incisions are often longer. A conversion definition that considers BMI and IL is needed.
authors.affiliation: New York-Presbyterian Hospital, Columbia Campus, New York, NY 10032, USA.
authors.forename: Anaeze C
authors.initials: AC
authors.lastname: Offodile
authors.forename: Emre
authors.initials: E
authors.lastname: Balik
authors.forename: Aviad
authors.initials: A
authors.lastname: Hoffman
authors.forename: Victor
authors.initials: V
authors.lastname: Moon
authors.forename: Raymond
authors.initials: R
authors.lastname: Baxter
authors.forename: Michael
authors.initials: M
authors.lastname: Grieco
authors.forename: Dovid
authors.initials: D
authors.lastname: Moradi
authors.forename: Ik-yong
authors.initials: IY
authors.lastname: Kim
authors.forename: Abu
authors.initials: A
authors.lastname: Nasar
authors.forename: Vesna
authors.initials: V
authors.lastname: Cekic
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Feingold
authors.forename: Tracey D
authors.initials: TD
authors.lastname: Arnell
authors.forename: Emina
authors.initials: E
authors.lastname: Huang
authors.forename: Richard L
authors.initials: RL
authors.lastname: Whelan
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D015992:Body Mass Index; D003082:Colectomy / Q000379:methods*; D003657:Decision Making; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D018579:Patient Selection; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies