Laparoscopic versus open resection without splenic flexure mobilization for the treatment of rectum and sigmoid cancer: a study from a single institution that selectively used splenic flexure mobilization.
BACKGROUND
We have hypothesized that splenic flexure mobilization might be selectively undertaken in laparoscopic surgery (LAP) for rectal or sigmoid colon cancer.


METHODS
Oncologic clearance and postoperative morbidity were compared between 119 LAP patients and 145 open surgery (OS), all of whom were treated without splenic flexure mobilization.


RESULTS
The operative time was similar in the 2 groups (P>0.05). The complication rate was lower after LAP than after OS (10.0% vs. 25.5%, P=0.043). Anastomotic leakage occurred in 1 patient after LAP. On a median 29-month follow-up, the local recurrence rates did not differ significantly between the 2 groups (0.9% for LAP vs. 2.6% for OS).


CONCLUSIONS
Laparoscopic procedures without routine splenic flexure mobilization do not increase postoperative morbidity or oncologic risk, as compared with OS. We suggest that laparoscopic rectal and sigmoid cancer resection can be safely conducted with selective splenic flexure mobilization.
Park
Jun Seok
JS
Department of Surgery, College of Medicine, Chung-Ang University, Seoul, Korea.
Kang
Sung-Bum
SB
Kim
Duck-Woo
DW
Lee
Kyoung Ho
KH
Kim
Young Hoon
YH
D000714:Anastomosis, Surgical; D044684:Colon, Transverse / Q000601:surgery*; D019992:Databases as Topic; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012811:Sigmoid Neoplasms / Q000473:pathology / Q000601:surgery*