Impact of splenic flexure mobilization on short-term outcomes after laparoscopic left colectomy for colorectal cancer.
BACKGROUND
Depending on the extent of left colon resection, splenic flexure mobilization is sometimes necessary to achieve a tension-free anastomosis. The aim of the study was the assessment of necessity and impact on morbidity of splenic flexure mobilization for laparoscopic colectomy with anastomosis for cancer located distally to the splenic flexure.


METHODS
Patients subjected to laparoscopic colectomy for carcinoma located at any site from the descending colon to the distal rectum from 2004 to 2010 were reviewed. Comparisons were made between cases with and without splenic flexure mobilization.


RESULTS
A total of 229 patients were operated for left colon or rectal cancer. There was no difference with regard to the intraoperative bleeding and bowel perforation and no differences concerning the conversion rates. In contrast, stoma formation rates were higher in the mobilized group. Moreover, total operative time was higher for the mobilized group except for the middle rectum cancer cases. Postoperative outcomes as far as mortality and morbidity rates and primary hospital stay are concerned, did not display any difference.


CONCLUSIONS
Splenic flexure mobilization can provide a tension-free anastomosis and sufficiently vascularized anastomosis in laparoscopic colorectal surgery for distal colon pathology, with no impact on immediate postoperative outcomes, despite longer operative time.
*1st Department of General Surgery, Agia Olga Hospital ‡2nd Department of General Surgery, Athens Naval and Veterans Hospital, Athens †Department of General Surgery, Hatzikosta Hospital, Ioannina, Greece.
Nikolaos
N
Gouvas
George
G
Gogos-Pappas
Konstantinos
K
Tsimogiannis
Christos
C
Agalianos
Evaghelos
E
Tsimoyiannis
Christos
C
Dervenis
Evaghelos
E
Xynos
D000714:Anastomosis, Surgical; D003082:Colectomy / Q000379:methods*; D044684:Colon, Transverse / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications; D054047:Surgical Stomas; D016896:Treatment Outcome