EP745 - Impact of side of resection (right vs. left) on outcomes after segmental colectomy: does side still matter?

Monday, May 12, 2025

10:42 AM – 10:47 AM PT

ePoster Presenter(s)

AA

Amirbahador Abbasi, MD, MPH

Postdoctoral Research Fellow
Global Center for Integrated Colorectal Surgery & IBD Interventional Endoscopy Columbia University Irving Medical Center / New York Presbyterian Hospital
New York, NY, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

BC

Beatrix H. Choi, MD

Resident Physician
Global Center for Integrated Colorectal Surgery & IBD Interventional Endoscopy Columbia University Irving Medical Center / New York Presbyterian Hospital
Columbia University Medical Center
New York, New York, United States

Disclosure information not submitted.
JC

James M. Church, MD

Professor of Surgery
Global Center for Integrated Colorectal Surgery & IBD Interventional Endoscopy Columbia University Irving Medical Center / New York Presbyterian Hospital
Leola, Pennsylvania, United States

Disclosure information not submitted.
Usama Ahmed Ali, MD, MSc, PhD

Assistant Professor of Surgery
Global Center for Integrated Colorectal Surgery & IBD Interventional Endoscopy Columbia University Irving Medical Center / New York Presbyterian Hospital
New York, NY, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
Marco Zoccali, MD

Assistant Professor of Surgery
Global Center for Integrated Colorectal Surgery & IBD Interventional Endoscopy Columbia University Irving Medical Center / New York Presbyterian Hospital
Columbia University
New York, New York, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Senior Author(s)

RK

Ravi P. Kiran, MD

Professor of Surgery
Global Center for Integrated Colorectal Surgery & IBD Interventional Endoscopy Columbia University Irving Medical Center / New York Presbyterian Hospital
New York, New York, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Amirbahador Abbasi, MD, MPH: This individual has no financial relationships with ineligible companies.

Usama Ahmed Ali, MD, MSc, PhD: This individual has no financial relationships with ineligible companies.

Marco Zoccali, MD: This individual has no financial relationships with ineligible companies.

Ravi P. Kiran, MD: This individual has no financial relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: Traditional teaching suggests a greater risk of complications and surgical site infection after left when compared to right sided colectomy. Since our knowledge related to differences in outcomes for right vs. left colectomy predates the current perioperative protocols to optimize recovery and outcomes, we evaluate postoperative outcomes of right- and left-sided colectomies for patients managed by standardized protocols in the current era

Methods/Interventions: All patients undergoing right- and left-sided colectomies between 2014 to 2024 were identified from a prospectively maintained database at an academic institution. Demographic data, operative details, and 30-day postoperative outcomes were compared for these two groups. Dichotomous variables were compared using the Chi-square test, and the t-test or Mann-Whitney test were employed for continuous variables, as necessary. A p-value less than 0.05 was considered significant.

Results/Outcomes: Of 1951 patients who underwent colectomy, 1014 (52%) had left-sided while 937 (48%) right-sided colectomies. Left colectomy patients were younger (62 (IQR 52-71) vs. 65 (IQR 50-76) years, p=0.003) and had higher body mass index (27.2, IQR 23.7-30.4 vs. 25.4 kg/m2, IQR 22.3-29.7, p< 0.001) than right colectomy patients. Median length of stay (LOS) was similar (4(IQR 2-6) for left vs 4 (IQR 2-7) days for right colectomy, p=0.12). Operative time was significantly greater for left colectomy patients (174 (IQR 135-227) vs. 125 (IQR 94-169) minutes, p< 0.001). For 30-day complications, readmission (7.8% vs 9.0%, p=0.35) and reoperation (4.2% vs 3.2%, p=0.23) were similar. Mortality was also similar (1.6% left vs. 2.2% right colectomy (p=0.28)). Ileus (9.8% vs 6.7%, p=0.01) and transfusion were however higher after right vs. left colectomy (12.8% vs 9.1%, p=0.008). Other complications such as abscess (p=0.07), surgical site infections (SSI) (p=0.13), and venous thromboembolism (VTE) (p=0.06) were similar.

Conclusion/Discussion: Left colectomy is more technically demanding after right colectomy as also reflected by the significantly longer operative times in this study. Given the success of several standardized perioperative protocols that have dramatically reduced SSI and improved recovery after any colorectal surgery, the usual differences in leak and infectious complications after left colectomy seem to have been obtunded. Right colectomy was associated with a greater risk of complications since particularly ileus and blood transfusion are more common while other complications including anastomotic leak and SSI were similar. Risk stratification models need to consider side of colectomy as an important factor that influences outcomes.