Obstructing cancers of the right and left colon: critical analysis of perioperative risk factors, morbidity, and mortality.

Significant hospital mortality has been observed in right-sided obstructing colonic cancer patients but remains unexplained. The medical records of 52 patients with obstructing colonic cancer seen between 1980-88 were reviewed to identify prognostic factors influencing mortality when carcinoma involved either the right or the left segments of the colon. The mean age, sex, incidence, and distribution of perioperative risk factors and rate of postoperative complications were comparable between the two groups. Right colonic cancer patients had a higher incidence of advanced disease (16 of 19 had Dukes C and D tumors). Their mortality was higher than that of their counterparts (21% vs 9%), correlating primarily with advanced cancer stage rather than with preoperative risk factors or technical (operative) complications. Though the difference in mortality rates is not statistically significant, patients with obstructing cancers of the right colon, compared to their left counterparts, are hospitalized in more advanced stages of disease and have a worse prognosis.