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Introduction: Colocolonic or colorectal anastomosis perceived as more technically challenging than ileocolic anastomosis. Therefore, right colectomy (RC) is generally believed to be a simpler operation with better outcomes than left colectomy (LC). Objectives: Our study was intended to compare outcomes between right and left colectomy in patients with colon cancer and identify factors that increase the risk of developing postoperative abdominal abscess or anastomotic leakage (abscess/leak) in these patients. Methods: Using the 2007 Nationwide Inpatient Sample (NIS) database, patients who underwent elective RC and LC (left hemicolectomy or sigmoidectomy) for colon cancer were examined. Patient characteristics, comorbidities, perioperative complications, length of stay (LOS), total hospital charges and in-hospital mortality were evaluated. Regression analysis was performed to identify independent predictors of abscess/leakage. Results: A total of 50,799 patients underwent elective RC and LC for colon cancer during 2007 (RC: 63.54%; LC: 36.46%). Overall, 9.63% were performed laparoscopically (RC: 9.70% vs. LC: 9.47%, P=0.39). RC patients had more comorbidities. However, similar numbers of RC and LC patients had distant metastases at the time of surgery (30.7% vs. 30.8%; p=0.77). Table below shows outcome measures of RC and LC.Using multivariate regression analysis, Native American race [odds ratio (OR): 2.02], renal failure (OR: 1.97), congestive heart failure (OR: 1.72), chronic pulmonary disease (OR: 1.40), metastasis (OR: 1.34), male gender (OR: 1.23) and left colectomy (OR: 1.12) all independently increased the risk of abscess/leak. There was no effect of age, diabetes, hypertension, liver disease, obesity, anemia, peripheral vascular disorder and surgical technique (laparoscopic versus open) on abscess/leak in these patients.Conclusion: Patients in the right colectomy group were older and had more comorbidities and postoperative complications compared to the left colectomy group. In-hospital mortality and length of hospital stay were comparable between groups. Left colectomy had higher intraoperative complications and total hospital charges than right colectomy. Patient characteristics and comorbidities were more important in predicting abscess/leak than anastomotic types.
Outcome Measures of Right and Left Colectomy for Colon Cancer

Outcome Measures	Right ColectomyN=32,276	Left ColectomyN=18,523	P-value
Age (mean, year)	70.4	65.8	<0.01
Female (%)	54.2	46.5	<0.01
Caucasian (%)	80.0	75.7	<0.01
Patients with≥1 Intraoperative Complications (%)	0.30	1.32	<0.01
Overall Frequency of Postoperative Complications (%)	39.18	37.0	<0.01
Patients with ≥1 complication (%)	28.43	26.75	<0.01
Anastomotic Leakage (%)	1.63	1.50	0.252
Abdominal Abscess (%)	3.19	3.79	<0.01
Mean Length of Hospital stay (days)	7.37	7.38	0.93
In-hospital Mortality (%)	1.37	1.49	0.29
Mean Total Hospital Charges (\0	44,183	48,700	<0.01