• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

Impact of Splenic Flexure Mobilization in Laparoscopic Colectomy.

A Sanchez Ruiz, MD, E Grzona, MD, M Bun, MD, A Canelas, MD, M Laporte, MD, C Peczan, MD, N Rotholtz, MD

Colorectal Surgery Division – Hospital Aleman de Buenos Aires. Argentina.

BACKGROUND: Routine mobilization of the splenic flexure (SFM) for left colectomy and its variants is controversial. The pros are getting adequate surgical specimen; to retrieve sufficient number of nodes and minimize the incidence of anastomotic leak. The cons are that increases the complexity of the procedure and the operating time.

Objective: The aim of this study was to evaluate the impact of the (SFM) and to identify predictive factors that predispose its realization.

DESIGN: Retrospective analysis of a prospective database.

MATERIAL AND METHODS: A retrospective analysis based on a prospective database was performed on all patients operated between June 2000 to May 2012. All patients who underwent procedures that could potentially require MSF were included. The series was divided into three groups: left colectomy (CI); sigmoidectomy (S) and low anterior resection (LAR). Turn these groups were subdivided in those where the SFM wasn’t necessary (CI1; S1; RA1) and those where the SFM who performed (CI2; S2; RA2). Surgical time; complications rate; anastomotic leak rate; hospital length of stay; intestinal recovery; number of lymph nodes retrieved; and length of the specimen were the variables analyzed between the groups. The variables analyzed as predictors for MSF: age, sex, BMI ≥ 30 and ≥ 2 ASA.

RESULTS: 1076 laparoscopic colon surgeries were performed in the period of time analyzed. Of these, 593 were procedures with potential MSF. In 359 (60.5%) of cases the SFM was not performed. Subgroups were distributed as follows: CI1: 161 (27.1%); S1: 326 (55%); LAR1: 106 (17.9%); CI2: 118 (73%); S2: 69 (21.3%); and LAR2: 47 (44.3%). When CI group was analyzed subgroup 2 had a longer operative time (CI1vsCI2: 165vs214 min, p = <0.05); higher number of intraoperative complications (CI1vsCI2: 2.3vs8.5%, p = <0.05), fewer lymph nodes retrieved (CI1vsCI2: 17vs14, 8, p = <0.05) as well as increased length of the specimen (CI1vsCI2: 21 vs 25.7 cm, p = <0.05). There were no differences in the anastomotic leak rates. In the S group, only longer operative time was found in subgroup 2 (S1vsS2: 142vs192 min, p = <0.05). LAR2 had longer operative time (LAR1vsLAR2: 192vs 243 192 min, p = <0.05); longer length of stay (LAR1vsLAR2: 4.4 vs 6.8 days, p = <0.05); longer time for oral tolerance (LAR1vsLAR2: 1.5 vs. 2.7 days p = <0.05); bigger length of specimen (LAR1vsLAR2: 18.6vs22, 5 cm, P <0.05); but the number of lymph nodes removed was lower (LAR1vsLAR2: 16.5vs14, 6, p = <0.05). There were no difference in the rate of dehiscence. BMI> 30 was the only independent predictive factor to avoid the SFM into the three groups (p = <0.05).

CONCLUSIONS: SFM increases surgical time and intraoperative complications without reducing the risk of anastomotic leak. Based on these findings SFM should not be carried out routinely.


Session: Posters/Distinction

Program Number: P015

511

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons