title: Emergency surgery for obstructing colonic cancer: a comparison between right-sided and left-sided lesions.
abstract: OBJECTIVE
  Few studies compare management and outcomes of obstructive colonic cancer, depending on the tumor site. We aim to evaluate the differences in patient characteristics, tumor characteristics, and outcomes of emergency surgery for obstructive right-sided versus left-sided colonic cancers.
  
  
  METHODS
  Between 2000 and 2009, 71 consecutive patients had an emergency colectomy following strict and clear definition of obstruction in a single institution. We retrospectively analyzed pre, per, and postoperative data that were prospectively collected.
  
  
  RESULTS
  There were 31 and 40 patients in the right and left group, respectively. Patients aged over 80 were more frequent in the right group (p = 0.03). At operation, ileocecal valve was less often competent in the right group (p = 0.03). The one-stage strategy was more frequent in the right group (p = 0.008). Patients in the right group had a higher rate of nodes invasion (p = 0.04). One- and two-year mortality rate in the right group had a tendency to be higher.
  
  
  CONCLUSIONS
  Patients presenting with a right obstructive colonic cancer are older, have a more advanced locoregional disease, and are more often treated in a one-stage strategy than patients with a left obstructive tumor.
authors.affiliation: Colorectal Unit, Department of Surgery, Grenoble Alps University Hospital, 38000, Grenoble, France. JLFaucheron@chu-grenoble.fr.|University Grenoble Alps, UMR 5525, CNRS, TIMC-IMAG, 38000, Grenoble, France. JLFaucheron@chu-grenoble.fr.
authors.forename: J-L
authors.initials: JL
authors.lastname: Faucheron
authors.affiliation: Department of Surgery, University Hospital, 25030, Besançon Cedex, France.
authors.forename: B
authors.initials: B
authors.lastname: Paquette
authors.affiliation: Colorectal Unit, Department of Surgery, Grenoble Alps University Hospital, 38000, Grenoble, France.|University Grenoble Alps, UMR 5525, CNRS, TIMC-IMAG, 38000, Grenoble, France.
authors.forename: B
authors.initials: B
authors.lastname: Trilling
authors.affiliation: Department of Surgery, University Hospital, 25030, Besançon Cedex, France.
authors.forename: B
authors.initials: B
authors.lastname: Heyd
authors.affiliation: Department of Gastroenterology, University Hospital, 25030, Besançon Cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Koch
authors.affiliation: Department of Surgery, University Hospital, 25030, Besançon Cedex, France.|Department of Gastroenterology, University Hospital, 25030, Besançon Cedex, France.
authors.forename: G
authors.initials: G
authors.lastname: Mantion
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods / Q000401:mortality; D015179:Colorectal Neoplasms / Q000150:complications* / Q000401:mortality; D015897:Comorbidity; D004635:Emergency Medicine; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Colonic carcinoma; Colonic obstruction; Emergency surgery; Left colectomy; Right colectomy