Risk factors for severe postoperative complications after left colectomy: A multicenter, retrospective study

PURPOSE: The efficacy of laparoscopic surgery for left-sided colon cancer requiring splenic flexure mobilization is still unknown. This study investigates the risk factors for severe postoperative complications in patients undergoing laparoscopic left colectomy. METHODS: The subjects of this retrospective study were 353 consecutive patients who underwent laparoscopic left colectomy across seven participating hospitals between January, 2016 and December, 2024. Patients were divided into two groups according to the development of postoperative complications (POCs): a POC group (n = 70) and a non-POC group (n = 283). Severe POCs developed in 25 patients. RESULTS: The POC group included more female patients (71.4% vs. 51.6%, p = 0.003), more patients with poor performance status (p = 0.005), more patients with combined resection of adjacent organ (14.3% vs. 4.6%, p = 0.006), and more patients with distant metastases (22.9% vs. 10.6%, p = 0.002). The hospital stay was also significantly longer for the POC group patients (18 days vs. 11 days, p < 0.001). Multivariate analysis for severe complications identified that blood loss greater than 50 mL (odds ratio [OR] 2.820, 95% confidence interval [CI] 1.195–6.654; p = 0.017) and distant metastases (OR 2.671, 95%CI 1.021–6.987; p = 0.045) were independent predictors of severe POCs. CONCLUSIONS: Blood loss and distant metastases were risk factors for severe POCs after laparoscopic left colectomy.