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Cited 17 time in webofscience Cited 19 time in scopus
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Laparoscopic Rectal Resection Without Splenic Flexure Mobilization: A Prospective Study Assessing Anastomotic Safety

Authors
Kim, JinChoi, Dong-JinKim, Seon-Hahn
Issue Date
Sep-2009
Publisher
H G E UPDATE MEDICAL PUBLISHING S A
Keywords
Rectal cancer; Splenic flexure; Laparoscopy; Rectal resection; Anastomotic leak
Citation
HEPATO-GASTROENTEROLOGY, v.56, no.94-95, pp.1354 - 1358
Indexed
SCIE
SCOPUS
Journal Title
HEPATO-GASTROENTEROLOGY
Volume
56
Number
94-95
Start Page
1354
End Page
1358
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/15823
ISSN
0172-6390
Abstract
Background/Aims: It was hypothesized that a portion of the sigmoid colon and accompanying marginal artery can be preserved by omitting the complete mobilization of the splenic flexure, yet achieve safe anastomosis. This study was designed to compare the surgical safety of omitting splenic flexure mobilization during laparoscopic rectal surgery in patients with rectal cancer. Methodology: Between September 2006 and January 2008, laparoscopic rectal resection was performed in 160 consecutive patients with rectosigmoid and rectal cancer. Five patients who underwent abdominoperineal resection (APR) were excluded from this analysis. Morbidity and mortality were recorded prospectively. Splenic flexure mobilization (SFM), anastomotic leakage, bleeding, and stricture rate were analyzed in this group. Results: The median operative time was 225 min. There were no operative mortalities. SFM was required in 7 patients (4.5%). Anastomotic leakage occurred in 13 patients (8.4%), anastomotic bleeding occurred in 4 patients (2.6%), and 3 patients (1.9%) bad strictures. The median number of harvested lymph nodes was 19. Conclusions: A portion of the sigmoid colon can be safely used as the proximal bowel segment for anastomosis during laparoscopic rectal surgery, and thus full mobilization of the splenic flexure can be omitted.
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Kim, Jin
Anam Hospital (Department of Colon and Rectal Surgery, Anam Hospital)
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