title: How much colonic redundancy could be obtained by splenic flexure mobilization in laparoscopic anterior or low anterior resection?
abstract: OBJECTIVE
  Splenic flexure mobilization (SFM) is performed to ensure a tension free anastomosis with an adequate resection margin in laparoscopic anterior resection (AR) or low anterior resection (LAR). This retrospective study was performed to determine the amount of colonic redundancy that can be expected by SFM.
  
  
  METHODS
  Retrospective review of medical record for a total of 203 patients who underwent SFM during laparoscopic AR or LAR for the treatment of sigmoid colon or rectal cancer was performed.
  
  
  RESULTS
  The obtained redundancy of the colon by SFM was 27.81 ± 7.29 cm from the sacral promontory. The redundancy of the colon by SFM with high ligation of the inferior mesenteric vein (IMV) (29.54 ± 7.17 cm from the sacral promontory) was greater than that with low ligation of the IMV (24.94 ± 6.07 cm from the sacral promontory, P < 0.0001). It took about 9.82% of the total operation time to perform SFM. There was no intraoperative complication during SFM.
  
  
  CONCLUSIONS
  SFM during laparoscopic AR or LAR is a safe and feasible option. Based on the result of this study, one can gain about 27.81 cm redundancy of the colon by SFM.
authors.affiliation: 1. St. Vincent Hospital, Department of Surgery, College of Medicine, The Catholic University of Korea, Suwon, Korea.
authors.forename: Bong-Hyeon
authors.initials: BH
authors.lastname: Kye
authors.affiliation: 1. St. Vincent Hospital, Department of Surgery, College of Medicine, The Catholic University of Korea, Suwon, Korea.
authors.forename: Hyung-Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: 1. St. Vincent Hospital, Department of Surgery, College of Medicine, The Catholic University of Korea, Suwon, Korea.
authors.forename: Hyun-Sil
authors.initials: HS
authors.lastname: Kim
authors.affiliation: 2. Seoul St. Mary's Hospital, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jun-Gi
authors.initials: JG
authors.lastname: Kim
authors.affiliation: 1. St. Vincent Hospital, Department of Surgery, College of Medicine, The Catholic University of Korea, Suwon, Korea.
authors.forename: Hyeon-Min
authors.initials: HM
authors.lastname: Cho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008026:Ligation / Q000379:methods; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery; D008875:Middle Aged; D012007:Rectum / Q000601:surgery*; D013154:Spleen / Q000601:surgery*
keywords: laparoscopic anterior resection; laparoscopic low anterior resection; splenic flexure mobilization