PDF(Pubmed)
Abstract：
Background: Recent investigations have suggested that-sidedness is associated with the prognosis of colon cancer patients. However, the role of sidedness in surgical outcome is unclear. In this study, we tried to demonstrate the real role of sidedness in postoperative results for colon cancer patients receiving surgical intervention. Methods: This is a propensity score matching study using the database of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) from 2009 to 2013. Sidedness groups including right-sided and left-sided colon cancer were created according to the associated diagnosis and procedure codes. Postoperative 30-day mortality, morbidity, overall complications, and total length of hospital stay were analyzed after performing propensity score matching. Results: Out of a total of 24,436 colon cancer patients who received associated operations, 15,945 patients had right-sided cancer and 8941 patients had left-sided cancer. Right-sided colon cancer patients were accompanied by more preoperative comorbidities including old age, female sex, hypertension, dyspnea, anemia, hypoalbuminemia, and a high American Society of Anesthesiologists grade (SMD > 0.1). Postoperative mortality, morbidities including re-intubation, bleeding, urinary tract infection and deep vein thrombosis, postoperative overall complications, and total length of hospital stay were significantly associated with right-sided cancer (p < 0.05). After 1:1 propensity score matching, postoperative mortality was not significantly different between right-sided cancer (2.3%) and left-sided cancer (2.4%) patients. The patients with left-sided colon cancer had significantly more postoperative morbidities, more overall complications, and longer total length of hospital stay. Conclusions: Poor clinical characteristics and postoperative outcomes were noted in right-sided cancer patients. After propensity score matching, left-sided cancer patients had worse postoperative outcomes than those with right-sided cancer.
摘要：
背景：最近的研究表明，这种情况与结肠癌患者的预后有关。然而,侧方在手术结局中的作用尚不清楚.在这项研究中,对于接受手术干预的结肠癌患者，我们试图证明片面性在术后结果中的真正作用。方法：这是一项使用2009年至2013年美国外科医生学会-国家外科质量改进计划（ACS-NSQIP）数据库的倾向评分匹配研究。根据相关的诊断和程序代码创建包括右侧和左侧结肠癌的侧视组。术后30天死亡率,发病率，整体并发症,进行倾向评分匹配后，对住院总时间进行分析。结果：在接受相关手术的24,436例结肠癌患者中，15,945例患者患有右侧癌症，8941例患者患有左侧癌症。右半结肠癌患者术前合并症较多,包括高龄,女性性别,高血压,呼吸困难,贫血,低蛋白血症,和高美国麻醉医师协会等级（SMD>0.1）。术后死亡率,包括重新插管在内的疾病,出血,尿路感染和深静脉血栓形成，术后总体并发症，和住院总时间与右侧癌显著相关(p<0.05)。1:1倾向评分匹配后，右侧癌(2.3%)和左侧癌(2.4%)患者的术后死亡率无显著差异.左侧结肠癌患者术后并发症明显增多,更多的整体并发症，和更长的总住院时间。结论：右侧癌症患者的临床特征和术后结局较差。在倾向得分匹配后，左侧癌症患者的术后结局比右侧癌症患者差.
