title: Outcomes of right vs. left colectomy for colon cancer.
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.
authors.affiliation: Department of Surgery, University of California, Irvine Medical Center, Orange, CA 92868, USA.
authors.forename: Hossein
authors.initials: H
authors.lastname: Masoomi
authors.forename: Brian
authors.initials: B
authors.lastname: Buchberg
authors.forename: Phat
authors.initials: P
authors.lastname: Dang
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Carmichael
authors.forename: Steven
authors.initials: S
authors.lastname: Mills
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stamos
mesh_terms: D000038:Abscess / Q000453:epidemiology / Q000209:etiology; D000368:Aged; D057868:Anastomotic Leak / Q000453:epidemiology / Q000209:etiology; D002908:Chronic Disease; D003082:Colectomy / Q000379:methods*; D044682:Colon, Ascending / Q000473:pathology / Q000601:surgery*; D044683:Colon, Descending / Q000473:pathology / Q000601:surgery*; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006333:Heart Failure / Q000150:complications; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data; D007431:Intraoperative Complications / Q000453:epidemiology*; D007676:Kidney Failure, Chronic / Q000150:complications; D007902:Length of Stay / Q000706:statistics & numerical data; D008171:Lung Diseases / Q000150:complications; D008297:Male; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D014481:United States