H. Aziz1, M. R. Torres1, V. Nfonsam1 1University Of Arizona,Tucson, AZ, USA
Introduction:
Optimization of surgical outcomes after colectomy continues to be actively studied, but most studies group right-sided and left-sided colectomies together. The aim of our study was determine whether the complication rate differs between right-sided and left-sided colectomies for cancer.
Methods:
We identified patients who underwent laparoscopic colectomy for colon cancer in the 2005-2010 American College of Surgeons National Surgical Quality Improvement Program database and stratified cases by right and left side. The two groups were matched using propensity score matching for demographics, previous abdominal surgery, pre-operative chemotherapy and radiotherapy, and pre-operative laboratory data. Outcome measures were: 30-day mortality and morbidity.
Results:
We identified 2,512 patients who underwent elective laparoscopic colectomy for right-sided or left-sided colon cancer in the database. The two groups were similar in demographics, and pre-operative characteristics. There was no difference in overall morbidity (15% vs 15.7%; p-0.8) or 30 day mortality (1.5% vs 1.5%; p-0.9) between the two groups. Sub-analysis revealed higher surgical site infection rates (9% vs 6%; p-0.04), higher incidence of ureteral injury(0.6% vs 0.49%; p-0.04), higher conversion rate to open colectomy (51% vs. 30%; p-0.01) and a longer hospital length of stay (10.5+/-4 vs. 7.1+/-1.3 days; p-0.02) in patients undergoing laparoscopic left colectomy.
Conclusion:
Our study highlights the difference in complications between right-sided and left-sided colectomies for cancer. Further research on outcomes after colectomy should incorporate right vs left side colon resection as a potential preoperative risk factor.
