eP182 - Right Colectomy Is Associated with Long Term Increased Risk for Left Sided Colonic Pathologies

ePoster Presenter(s)

• SK

  Saed Khalilieh, MD

  Resident - General surgery
  Department of General Surgery and Transplantations, Sheba Medical Center, Tel Hashomer, Israel.
  Department of General Surgery and Transplantations, Sheba Medical Center, Tel Hashomer, Israel.
  Tel aviv, HaMerkaz, Israel

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

Author(s)

• EG

  Eliyahu Gorgov, MD

  Resident - Surgery
  2. Department of General Surgery, Assuta Medical Centers, Ashdod, Israel.
  Ashdod, HaDarom, Israel

  Disclosure information not submitted.
• AN

  Avinoam Nevler, n/a

  Associate Prof
  3. Jefferson Pancreas, Biliary and Related Cancer Center, Department of Surgery, Thomas Jefferson University, Philadelphia, PA
  Philadelphia, Pennsylvania, United States

  Disclosure information not submitted.
• ER

  Edward Ram, MD

  Associate Prof
  1. Department of General Surgery and Transplantations, Sheba Medical Center, Tel Hashomer, Israel.
  Ramat gan, HaMerkaz, Israel

  Disclosure information not submitted.

Senior Author(s)

• 

  Nir Horesh, MD

  Clinical Fellow
  Cleveland Clinic Florida
  Cleveland Clinic Florida
  Weston, FL, United States

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

Author(s)

• 

  Meagan Derbyshire, MD (she/her/hers)

  Colorectal Surgery Fellow
  Advent Health Orlando
  Winter Park, FL, United States

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

  Yaniv Zager, MD

  Fellow
  Adventhealth
  Althamone Springs, FL, United States

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

Purpose/Background: Right hemicolectomy is an operation performed frequently performed for right sided colon cancer. The effect that right sided colectomy has on left sided colonic pathologies has not been thoroughly studied.The aim of this study is to evaluate the long-term risk for benign and malignant left sided colonic pathologies following right hemicolectomy.Methods/Interventions: We conducted a retrospective study using TriNteX- a federated research network (FRN), including adult patients who underwent right hemicolectomy compared to controls, patients with history of inflammatory bowel disease were excluded. Study primary outcomes were 10-year risk of developing benign and malignant left colon pathologies including diverticulitis, sigmoid volvulus, as well as malignancy of descending/sigmoid colon and rectum. Propensity score matching was used to including matching for age, sex, race, diabetes mellitus, obesity, and nicotine use.Results/Outcomes: The FRN analysis included 29,844 patients who underwent right sided colonic resection and 9,096,374 patients in the control group. After propensity score matching, each group included 28,797 patients with a mean age of 66.2±15.4 years, equal distribution of male and females in both groups (52.6% and 47.4% respectively), 25% of the patients suffered from diabetes mellitus and 23.4% were overweight. Long term risk for volvulus and diverticulitis were increased 4.8-fold (95%CI 3.43, 6.9 p < 0.0001) and 1.6-fold (95%CI 1.38, 1.88 p < 0.0001) respectively in the right-sided colectomy group as compared to control group (Figure1A-B). Moreover, the right-sided colectomy group had 5.68-fold (95%CI 4.67, 6.59 p < 0.0001) increased risk for developing left-sided colonic and rectal cancer (Figure 1C). Patients in the right-sided colectomy group had 2.11-fold (95%CI 1.49, 2.98 p < 0.0001) increased risk for undergoing additional colorectal resection (Figure 1D).Conclusion/

Discussion: Our results suggest higher incidence of both benign and malignant left sided colon pathologies among patients that underwent right colectomy. Further studies are warranted to investigate pathophysiology and the need for change in primary and secondary prevention policies.Figure 1.FRN analysis demonstrated long term increased risk for left sided benign pathologies after right sided colonic resection (1A. volvulus, 2B. diverticulitis). Additionally, our analysis showed increased risk for colon and rectal cancer (1C). Finally, our analysis showed increased risk for left sided and rectal resections following right sided colonic resection (1D).