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.
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 cancerpatients, 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.
Authors: Ankur R Rana; Jamie A Cannon; Gamal Mostafa; Alfredo M Carbonell; Kent W Kercher; H James Norton; B Todd Heniford Journal: Surg Innov Date: 2007-06 Impact factor: 2.058
Authors: Thomas M Schmelzer; Gamal Mostafa; Amy E Lincourt; Steven M Camp; Kent W Kercher; Timothy S Kuwada; B Todd Heniford Journal: J Surg Res Date: 2007-09-14 Impact factor: 2.192
Authors: Omar Faiz; Janindra Warusavitarne; Alex Bottle; Paris P Tekkis; Sue K Clark; Ara W Darzi; Paul Aylin Journal: J Am Coll Surg Date: 2010-04 Impact factor: 6.113
Authors: Robert L Smith; Jamie K Bohl; Shannon T McElearney; Charles M Friel; Margaret M Barclay; Robert G Sawyer; Eugene F Foley Journal: Ann Surg Date: 2004-05 Impact factor: 12.969
Authors: Matteo Frasson; Pablo Granero-Castro; José Luis Ramos Rodríguez; Blas Flor-Lorente; Mariela Braithwaite; Eva Martí Martínez; Jose Antonio Álvarez Pérez; Antonio Codina Cazador; Alejandro Espí; Eduardo Garcia-Granero Journal: Int J Colorectal Dis Date: 2015-08-28 Impact factor: 2.571