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International Journal of Colorectal Disease

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01-11-2012 | Original Article

Different approaches for complete mobilization of the splenic flexure during laparoscopic rectal cancer resection

Authors: Volker Benseler, Matthias Hornung, Igors Iesalnieks, Philipp von Breitenbuch, Gabriel Glockzin, Hans J. Schlitt, Ayman Agha

Published in: International Journal of Colorectal Disease | Issue 11/2012

Abstract

Purpose

Laparoscopic resection of rectal cancer has already become the standard procedure in many hospitals. The splenic flexure mobilization (SFM) is an important preparational step. Several methods are used for laparoscopic SFM; however, studies comparing different approaches are lacking. In the present study, three different approaches for SFM have been compared to each other.

Methods

Between January 1998 and December 2010, 415 patients with rectal adenocarcinoma underwent laparoscopic rectal resection at one center. Of these, 303 patients received complete splenic flexure mobilization. The SFM was performed using either a medial (SFM-M; n = 41), lateral (SFM-L; n = 214), or anterior (SFM-A; n = 48) approach.

Results

There was a significantly higher rate of intraoperative complications in the SFM-L group as compared to the SFM-M or the SFM-A group (p = 0.038). Postoperative surgical complications occurred in 5 (10.6 %) patients of the SFM-A group compared to 38 patients (17.7 %) in the SFM-L group (p = 0.002) and 5 (12.1 %) patients in the SFM-M group (p = 0.037). SFM-L was also associated with a higher frequency of overall postoperative morbidity which was mainly due to wound infection rates (p = 0.001).

Conclusions

The anterior approach for SFM in laparoscopic surgery seems to be associated with lower frequency of intra- and postoperative morbidity.

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Title: Different approaches for complete mobilization of the splenic flexure during laparoscopic rectal cancer resection
Authors: Volker Benseler
Matthias Hornung
Igors Iesalnieks
Philipp von Breitenbuch
Gabriel Glockzin
Hans J. Schlitt
Ayman Agha
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 11/2012
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-012-1495-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Different approaches for complete mobilization of the splenic flexure during laparoscopic rectal cancer resection

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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