caa a22 4500 475779886 CHVBK 20180406123641.0 cr unu---uuuuu 170329e20001201xx s 000 0 eng 10.1007/s004640000309 doi (NATIONALLICENCE)springer-10.1007/s004640000309 Predicting conversion to open surgery in laparoscopic colorectal resections [Elektronische Daten] A simple clinical model [C. M. Schlachta, J. Mamazza, P. A. Seshadri, M. O. Cadeddu, E. C. Poulin] Objective: The objective of this study was to develop a simple model for clinical use in predicting the individual risk of conversion to open surgery in patients undergoing laparoscopic colorectal resections. Methods: A multiple logistic regression analysis of 367 laparoscopic colorectal resections completed between 1991 and 1998 was performed. The following 13 factors were considered: patient-specific factors (age, gender, weight levels less than 60 kg 60-90 kg, 90 kg or more), disease-specific factors (Crohn's disease, diverticulitis, malignancy, fistula), and procedure-specific factors (resection of the hepatic flexure, splenic flexure, sigmoid, rectum, perineum, experience with less than 50 cases). A scoring system was developed on the basis of the three factors found to be predictive of the risk for conversion to open surgery: diagnosis of malignancy (odds ratio 3.23; p= 0.0037; one point), surgeon experience with 50 cases or less (odds ratio 2.26; p= 0.0363; one point), and weight level (odds ratio 3.42; p= 0.005; 60 to 90 kg, one point, 90 kg or more, two points). Results: The predicted conversion rates for the cumulative scores of 0 to 4 points were 1.1%, 3.3%, 9.8%, 25.4%, and 49.7%, respectively. No significant difference was found between predicted and actual conversion rates, indicating a good fit of the model (chi square = 1.774; p > 0.5). Conclusions: This novel scoring system is simple, accurate, and readily applicable in an office setting. It represents the large experience of one surgical group and remains to be validated by other centers. Springer-Verlag New York Inc., 2000 Key words: Colorectal surgery — Conversion — Laparoscopic surgery nationallicence Schlachta C. M. The University of Toronto Centre for Minimally Invasive Surgery, St. Michael's Hospital, Wellesley Central Site 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, CA aut Mamazza J. The University of Toronto Centre for Minimally Invasive Surgery, St. Michael's Hospital, Wellesley Central Site 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, CA aut Seshadri P. A. The University of Toronto Centre for Minimally Invasive Surgery, St. Michael's Hospital, Wellesley Central Site 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, CA aut Cadeddu M. O. The University of Toronto Centre for Minimally Invasive Surgery, St. Michael's Hospital, Wellesley Central Site 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, CA aut Poulin E. C. The University of Toronto Centre for Minimally Invasive Surgery, St. Michael's Hospital, Wellesley Central Site 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, CA aut Surgical Endoscopy Springer-Verlag 14/12(2000-12-01), 1114-1117 0930-2794 14:12<1114 2000 14 464 https://doi.org/10.1007/s004640000309 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640000309 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Schlachta C. M. The University of Toronto Centre for Minimally Invasive Surgery, St. Michael's Hospital, Wellesley Central Site 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, CA aut NATIONALLICENCE 700 1- Mamazza J. The University of Toronto Centre for Minimally Invasive Surgery, St. Michael's Hospital, Wellesley Central Site 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, CA aut NATIONALLICENCE 700 1- Seshadri P. A. The University of Toronto Centre for Minimally Invasive Surgery, St. Michael's Hospital, Wellesley Central Site 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, CA aut NATIONALLICENCE 700 1- Cadeddu M. O. The University of Toronto Centre for Minimally Invasive Surgery, St. Michael's Hospital, Wellesley Central Site 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, CA aut NATIONALLICENCE 700 1- Poulin E. C. The University of Toronto Centre for Minimally Invasive Surgery, St. Michael's Hospital, Wellesley Central Site 160 Wellesley Street East, Jones Building #219A, Toronto, Ontario, Canada M4Y 1J3, CA aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/12(2000-12-01), 1114-1117 0930-2794 14:12<1114 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer