Skip to main content

Advertisement

SpringerLink
Log in

Right versus left laparoscopic colectomy for colon cancer: does side make any difference?

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

To compare the intraoperative and postoperative outcomes between right laparoscopic colectomy (RLC) and left laparoscopic colectomy (LLC) for colon cancer.

Method

Patients who underwent elective RLC or LLC for colon cancer between January 2004 and December 2014 were identified and elected for a retrospective analysis. Primary outcomes were technical difficulty (including operative time, intraoperative complications, and conversion rate) and postoperative outcome (including postoperative complications, length of hospital stay, reinterventions, readmissions, and mortality).

Results

A total of 547 patients (mean age: 68.5 years old; 48.4% males) were analyzed. The RLC group had a higher mean age (71 vs 65; p < 0.001), ASA 3/4 grade (36 vs 26%; p = 0.02), and comorbidity rate (61 vs 48%, p = 0.003). Regarding technical difficulty, no difference was found between the groups in intraoperative complications (4.1 vs 5.9%; p = 0.34) or conversion rate (6.2 vs 3.9%, p = 0.24). Mean operative time was significantly shorter for RLC (162 vs 185 min, p < 0.001). Regarding postoperative outcome, the RLC group had a higher overall morbidity (20.5 vs 13.3%, p = 0.03), ileus (10.6 vs 2.4%, p < 0.001), and a longer hospital stay (4.7 vs 3.9 days, p = 0.003), with no differences regarding reoperations, readmissions, or mortality. The multivariate analysis showed that RLC were independently associated with a longer operative time and postoperative ileus.

Conclusions

RLC for colon cancer was independently associated with a shorter operative time, an increased risk of ileus, and a longer hospital stay than left laparoscopic colectomy in high-volume centers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Jamali FR, Soweid AM, Dimassi H, Bailey C, Leroy J, Marescaux J (2008) Evaluating the degree of difficulty of laparoscopic colorectal surgery. Arch Surg 143(8):762–767 . doi:10.1001/archsurg.143.8.762discussion 768

    Article  PubMed  Google Scholar 

  2. Yasunaga H, Matsuyama Y, Ohe K, Japan Surgical S (2009) Effects of hospital and surgeon volumes on operating times, postoperative complications, and length of stay following laparoscopic colectomy. Surg Today 39(11):955–961. doi:10.1007/s00595-008-4052-8

    Article  PubMed  Google Scholar 

  3. van Erning FN, van Steenbergen LN, van den Broek WT, Rutten HJ, Lemmens VE (2013) No difference between lowest and highest volume hospitals in outcome after colorectal cancer surgery in the southern Netherlands. Eur J Surg Oncol 39(11):1199–1206. doi:10.1016/j.ejso.2013.08.020

    Article  PubMed  Google Scholar 

  4. Benedix F, Kube R, Meyer F, Schmidt U, Gastinger I, Lippert H, Colon/Rectum Carcinomas Study G (2010) Comparison of 17,641 patients with right- and left-sided colon cancer: differences in epidemiology, perioperative course, histology, and survival. Dis Colon rectum 53(1):57–64. doi:10.1007/DCR.0b013e3181c703a4

  5. Kwaan MR, Al-Refaie WB, Parsons HM, Chow CJ, Rothenberger DA, Habermann EB (2013) Are right-sided colectomy outcomes different from left-sided colectomy outcomes?: study of patients with colon cancer in the ACS NSQIP database. JAMA Surg 148(6):504–510. doi:10.1001/jamasurg.2013.1205

    Article  PubMed  Google Scholar 

  6. Hinojosa MW, Konyalian VR, Murrell ZA, Varela JE, Stamos MJ, Nguyen NT (2007) Outcomes of right and left colectomy at academic centers. Am Surg 73(10):945–948

    PubMed  Google Scholar 

  7. Masoomi H, Buchberg B, Dang P, Carmichael JC, Mills S, Stamos MJ (2011) Outcomes of right vs. left colectomy for colon cancer. J Gastrointest Surg 15(11):2023–2028. doi:10.1007/s11605-011-1655-y

    Article  PubMed  Google Scholar 

  8. Mosteller RD (1987) Simplified calculation of body-surface area. N Engl J Med 317(17):1098. doi:10.1056/NEJM198710223171717

    CAS  PubMed  Google Scholar 

  9. Vaccaro CA, Vaccarezza H, Rossi GL, Mentz R, Im VM, Quintana GO, Peralta N, Soriano ER (2012) Body surface area: a new predictor factor for conversion and prolonged operative time in laparoscopic colorectal surgery. Dis Colon rectum 55(11):1153–1159. doi:10.1097/DCR.0b013e3182686230

  10. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196. doi:10.1097/SLA.0b013e3181b13ca2

    Article  PubMed  Google Scholar 

  11. Vaccaro CA, Rossi GL, Quintana GO, Soriano ER, Vaccarezza H, Rubinstein F (2014) Laparoscopic colorectal resections: a simple predictor model and a stratification risk for conversion to open surgery. Dis Colon rectum 57(7):869–874. doi:10.1097/DCR.0000000000000137

  12. Rossi G, Vaccarezza H, Vaccaro CA, Mentz RE, Im V, Alvarez A, Quintana GO (2013) Two-day hospital stay after laparoscopic colorectal surgery under an enhanced recovery after surgery (ERAS) pathway. World J Surg 37(10):2483–2489. doi:10.1007/s00268-013-2155-x

    Article  PubMed  PubMed Central  Google Scholar 

  13. Chan AC, Poon JT, Fan JK, Lo SH, Law WL (2008) Impact of conversion on the long-term outcome in laparoscopic resection of colorectal cancer. Surg Endosc 22(12):2625–2630. doi:10.1007/s00464-008-9813-3

    Article  PubMed  Google Scholar 

  14. Turrado-Rodriguez V, Targarona Soler E, Bollo Rodriguez JM, Balague Ponz C, Hernandez Casanovas P, Martinez C, Trias Folch M (2015) Are there differences between right and left colectomies when performed by laparoscopy? Surg Endosc. doi:10.1007/s00464-015-4345-0

    PubMed  Google Scholar 

  15. Veyrie N, Ata T, Muscari F, Couchard AC, Msika S, Hay JM, Fingerhut A, Dziri C, French Associations for Surgical R (2007) Anastomotic leakage after elective right versus left colectomy for cancer: prevalence and independent risk factors. J Am Coll Surg 205 (6):785–793. doi:10.1016/j.jamcollsurg.2007.06.284

  16. Rana AR, Cannon JA, Mostafa G, Carbonell AM, Kercher KW, Norton HJ, Heniford BT (2007) Outcomes of right- compared with left-side colectomy. Surg Innov 14(2):91–95. doi:10.1177/1553350607303209

    Article  PubMed  Google Scholar 

  17. Tekkis PP, Senagore AJ, Delaney CP, Fazio VW (2005) Evaluation of the learning curve in laparoscopic colorectal surgery. Ann Surg 242(1):83–91. doi:10.1097/01.sla.0000167857.14690.68

    Article  PubMed  PubMed Central  Google Scholar 

  18. Masoomi H, Moghadamyeghaneh Z, Mills S, Carmichael JC, Pigazzi A, Stamos MJ (2015) Risk factors for conversion of laparoscopic colorectal surgery to open surgery: does conversion worsen outcome? World J Surg 39(5):1240–1247. doi:10.1007/s00268-015-2958-z

    Article  PubMed  Google Scholar 

  19. Gouvas N, Gogos-Pappas G, Tsimogiannis K, Agalianos C, Tsimoyiannis E, Dervenis C, Xynos E (2014) Impact of splenic flexure mobilization on short-term outcomes after laparoscopic left colectomy for colorectal cancer. Surg Laparosc Endosc Percutan Tech 24(5):470–474. doi:10.1097/SLE.0b013e31829ce62a

    Article  PubMed  Google Scholar 

  20. Feroci F, Lenzi E, Garzi A, Vannucchi A, Cantafio S, Scatizzi M (2013) Intracorporeal versus extracorporeal anastomosis after laparoscopic right hemicolectomy for cancer: a systematic review and meta-analysis. Int J Color Dis 28(9):1177–1186. doi:10.1007/s00384-013-1651-7

    Article  Google Scholar 

  21. Senagore AJ, Delaney CP, Brady KM, Fazio VW (2004) Standardized approach to laparoscopic right colectomy: outcomes in 70 consecutive cases. J Am Coll Surg 199(5):675–679. doi:10.1016/j.jamcollsurg.2004.06.021

    Article  PubMed  Google Scholar 

  22. Simillis C, Purkayastha S, Yamamoto T, Strong SA, Darzi AW, Tekkis PP (2007) A meta-analysis comparing conventional end-to-end anastomosis vs. other anastomotic configurations after resection in Crohn’s disease. Dis Colon rectum 50(10):1674–1687. doi:10.1007/s10350-007-9011-8

Download references

Author information

Authors and Affiliations

  1. Section of Colorectal Surgery, Department of General Surgery, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1181ACH, Buenos Aires, Argentina

    Juan P. Campana, Pablo A. Pellegrini, Gustavo L. Rossi, Guillermo Ojea Quintana, Ricardo E. Mentz & Carlos A. Vaccaro

Authors
  1. Juan P. Campana
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pablo A. Pellegrini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gustavo L. Rossi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Guillermo Ojea Quintana
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ricardo E. Mentz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Carlos A. Vaccaro
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carlos A. Vaccaro.

Ethics declarations

Funding

There was no funding for this study.

Conflicts of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Campana, J.P., Pellegrini, P.A., Rossi, G.L. et al. Right versus left laparoscopic colectomy for colon cancer: does side make any difference?. Int J Colorectal Dis 32, 907–912 (2017). https://doi.org/10.1007/s00384-017-2776-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-017-2776-x

Keywords

Search

Navigation