title: Are right-sided colectomy outcomes different from left-sided colectomy outcomes?: study of patients with colon cancer in the ACS NSQIP database.
abstract: OBJECTIVE
  Optimization of surgical outcomes after colectomy continues to be actively studied, but most studies group right-sided and left-sided colectomies together.
  
  
  OBJECTIVE
  To determine whether the complication rate differs between right-sided and left-sided colectomies for cancer. As a secondary analysis, we investigated hospital length of stay.
  
  
  METHODS
  We identified patients who underwent colectomy for colon cancer in the 2005-2008 American College of Surgeons National Surgical Quality Improvement Program database and stratified cases by right and left side. Preoperative, intraoperative, and postoperative factors were compared. Multivariable techniques were used to assess the impact of the side of colectomy on operative outcome measures, adjusting for covariates.
  
  
  METHODS
  Hospitals within the American College of Surgeons National Surgical Quality Improvement Program database.
  
  
  METHODS
  We identified 4875 patients who underwent elective laparoscopic or open colectomy for right-sided or left-sided colon cancer in the database.
  
  
  METHODS
  Major complications and surgical site infection (SSI) rates.
  
  
  RESULTS
  In the 4875 colectomies studied, a laparoscopic approach was used in 42% of cases and at similar frequency in right-sided and left-sided colectomies. Thirty-day mortality (1.5%) was similar in both groups. Major complications were seen in 17% of patients in each group. Superficial SSI was more likely to occur in patients who underwent left-sided colectomy (8.2% vs 5.9%). Among patients with postoperative sepsis or deep or organ space SSIs, more patients in the left-sided colectomy group underwent reoperation compared with the right-sided colectomy group (56% vs 30%). Laparoscopic right-sided colectomy patients were more likely to have a prolonged hospital length of stay than laparoscopic left-sided colectomy patients (odds ratio, 1.39; 95% CI, 1.09-1.78).
  
  
  CONCLUSIONS
  The outcomes after colectomy for cancer are comparable in right-sided and left-sided resections, except for in the case of superficial SSI, which is less common in right-sided resections. Further research on SSI after colectomy should incorporate right vs left side as a potential preoperative risk factor.
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA. mkwaan@umn.edu
authors.forename: Mary R
authors.initials: MR
authors.lastname: Kwaan
authors.forename: Waddah B
authors.initials: WB
authors.lastname: Al-Refaie
authors.forename: Helen M
authors.initials: HM
authors.lastname: Parsons
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Chow
authors.forename: David A
authors.initials: DA
authors.lastname: Rothenberger
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Habermann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D003082:Colectomy / Q000009:adverse effects / Q000379:methods; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D039702:Current Procedural Terminology; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000473:pathology; D016896:Treatment Outcome