Outcomes of Right vs. Left Colectomy for Colon Cancer

  • Hossein Masoomi
  • Brian Buchberg
  • Phat Dang
  • Joseph C. Carmichael
  • Steven Mills
  • Michael J. Stamos
Original Article

DOI: 10.1007/s11605-011-1655-y

Cite this article as:
Masoomi, H., Buchberg, B., Dang, P. et al. J Gastrointest Surg (2011) 15: 2023. doi:10.1007/s11605-011-1655-y

Abstract

Background

Right colectomy (RC) is generally believed to be a simpler operation with better outcomes than left colectomy (LC). Our study was primarily intended to compare patient characteristics and perioperative outcomes between RC and LC in colon cancer patients, and secondarily to identify factors that increase the risk of developing postoperative abdominal abscess and/or anastomotic leak.

Methods

Using the 2007 Nationwide Inpatient Sample database, we evaluated patients who underwent elective RC and LC for colon cancer.

Results

A total of 50,799 patients underwent elective RC and LC for malignancy during 2007 (RC, 63.5%; LC, 36.5%). Overall, 9.6% were performed laparoscopically (RC, 9.7% vs. LC, 9.5%, P = 0.39). The majority of patients were Caucasian; 54.2% of RC and 46.5% LC patients were female (P < 0.01). RC patients were older (mean age, 70.8 vs. 65.8 years, P < 0.01) and had more comorbidities. While LC had more overall intraoperative complications (RC, 0.30% vs. LC, 1.32%, P < 0.01), RC had higher overall incidence of postoperative complications (28.43% vs. 26.75%, P < 0.01). Mean length of hospital stay (RC, 7.37 days vs. LC, 7.38 days) and in-hospital mortality (RC, 1.37% vs. LC, 1.49%) were similar in both groups. Multivariate analysis identified Native American race [adjusted odd ratio (AOR), 2.02], chronic renal failure (AOR, 1.97), congestive heart failure (AOR, 1.72), chronic pulmonary disease (AOR, 1.40), metastatic disease (AOR, 1.34), male gender (AOR, 1.23), and LC (AOR, 1.12) all independently increased the risk of abscess and/or leak.

Conclusions

RC patients were older and had more comorbidities and postoperative complications. Patient characteristics and comorbidities were more important in determining overall postoperative complications than anastomotic types.

Keywords

Right colectomy Left colectomy Ileocolic anastomosis Colocolic anastomosis Colon cancer 

Copyright information

© The Society for Surgery of the Alimentary Tract 2011

Authors and Affiliations

  • Hossein Masoomi
    • 1
  • Brian Buchberg
    • 1
  • Phat Dang
    • 1
  • Joseph C. Carmichael
    • 1
  • Steven Mills
    • 1
  • Michael J. Stamos
    • 1
  1. 1.Department of SurgeryUniversity of California, Irvine Medical CenterOrangeUSA

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