Lengthening of the colon for low rectal anastomosis in a cadaveric study: how much can we gain?

Thum-umnuaysuk, S.; Boonyapibal, A.; Geng, Yingcai; Pattana-arun, Jirawat

doi:10.1007/s10151-012-0930-6

Cited by 33 publications

(28 citation statements)

References 8 publications

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“…It allows to achieve a straight segment of supple and well vascularized segment of the descending colon that can be easily anastomosed to the remnant rectum down in the pelvis in which some surgeons favor creating a recreational pouch to decrease frequency of bowel movement [5] . In a cadaveric study done by Thum-umnuaysuk et al [7] , a greater length of colon at 17.98 ± 6.80 cm was achieved and it reached statistical significance when high ligation of IMA and IMV coupled with SFM was done. In a separate cadaveric study by Araujo et al [11] , it was shown that an additional 10 to 28 cm segment of the descending colon can be gained if SFM was carried out with or without distal transverse colon mobilization.…”

Section: Sfmmentioning

confidence: 88%

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The role of splenic flexure mobilization in laparoscopic rectal surgery for rectal cancer

Geniales¹,

Chen²

2018

MIS

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How to cite this article: Ke TW, Geniales CR, Chen WTL. The role of splenic flexure mobilization in laparoscopic rectal surgery for rectal cancer. Mini-invasive Surg 2018;2:35. http://dx. AbstractLaparoscopic surgery for the treatment of colorectal cancer has gained an enormous advantage as compared to the traditional approach in terms of patient benefits. Although it has gained popularity among surgeons, there are still some contentious issues especially in laparoscopic rectal surgery. Splenic flexure mobilization is a crucial aspect of the procedure with complex technical details thereby establishing a learning curve that cannot be easily overcome. A team of colorectal surgeons at China Medical University Hospital adopted a standardized approach to laparoscopic rectal surgery particularly simplifying the steps involved in mobilizing the splenic flexure which is deemed as one of the difficult steps in the surgery.

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Section: Sfmmentioning

confidence: 88%

“…Left-sided CRC comprises two thirds of all colorectal malignancies. The standard surgical treatment is a complete oncologic resection with a primary anastomosis [7] . There were initial concerns about the potential risk of tumor cell dissemination during laparoscopy but this has not been validated.…”

Section: Introductionmentioning

confidence: 99%

The role of splenic flexure mobilization in laparoscopic rectal surgery for rectal cancer

Geniales¹,

Chen²

2018

MIS

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“…On the other hand, in favour of SFM as part of colorectal cancer surgery, there are several anatomical and oncological studies [23][24][25], which support its usefulness. As a matter of fact, it is plausible to speculate that SFM, extending the colon segment available for colorectal anastomosis, would reduce tension, preserve blood flow to the anastomosis and, subsequently, improve surgical outcomes.…”

Section: Splenic Flexure Mobilizationmentioning

confidence: 99%

Laparoscopic Colorectal Surgery for Cancer: What Is the Role of Complete Mesocolic Excision and Splenic Flexure Mobilization?

2017

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Laparoscopic colorectal surgery for cancer is nowadays routinely performed worldwide. After the introduction by Heald of total mesorectal excision for rectal cancer, also a complete mesocolic excision has been advocated as an essential surgical step to improve oncologic results in patients with colon cancer. The complete removal of mesocolon with high ligation of the main mesenteric arteries and veins and the mobilization of splenic flexure are well-known but still debated in western surgical society. The authors reviewed the literature and outlined the rationale and the results of splenic flexure mobilization and complete mesocolic excision in laparoscopic surgery for colorectal cancer.

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“…Complete oncologic resection is the standard surgical treatment if possible, with a primary anastomosis. 1 In 1991, Jacobs et al was the first one who describes laparoscopic colonic resection after that Laparoscopic colonic surgery has been employed for the treatment of colon cancer. 2 Several studies show that treatment of colorectal cancers can be performed by laparoscope with acceptable outcomes, while other studies show controversy for laparoscopic colorectal cancer surgeries.…”

Section: Introductionmentioning

confidence: 99%

Splenic flexure mobilization is an essential role in laparoscopic low anterior resection!

2019

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Background: Routine mobilization of splenic flexure whether partial or complete became an essential step in laparoscopic low anterior resections in order to perform an oncologic resection and to achieve a safe, tension-free anastomosis.Methods: 60 patients with rectal cancer were operated by laparoscopic low anterior resection with high ligation of inferior mesenteric artery in general surgery department, Menoufia university hospital between February 2016 and January 2019. All patients were divided randomly into 2 equal groups based on the techniques used in splenic flexure mobilization whether partial (group A) or complete (group B).Results: The majority of our patients were male 56.6% and 60% in both groups respectively with mean age (54.6±8.8) years in group A and mean age (58.5±9.2) years in group B. The operative time was highly significant lower in group A (269±17.6 minutes) than group B (304±22.4 minutes) while the conversion rate was significantly higher in group B (26.6%) than group A (6.6%). Regarding the postoperative data there was only significantly higher leak from the anastomosis in group A (20%) than group B (3.3%).Conclusions: Complete splenic flexure offer better oncological outcome and low incidence of anastomotic leak but with higher conversion rate, prolonged operative time, more blood loss and more 30 day mortality rate. So it needs more time to gain more experience to overcome these disadvantages.

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Lengthening of the colon for low rectal anastomosis in a cadaveric study: how much can we gain?

Abstract: This study shows the objective length gained following each standard surgical technique in colonic mobilization for low rectal anastomosis. The maximum length gained is after high ligation of IMV.

Cited by 33 publications

References 8 publications

The role of splenic flexure mobilization in laparoscopic rectal surgery for rectal cancer

The role of splenic flexure mobilization in laparoscopic rectal surgery for rectal cancer

Laparoscopic Colorectal Surgery for Cancer: What Is the Role of Complete Mesocolic Excision and Splenic Flexure Mobilization?

Splenic flexure mobilization is an essential role in laparoscopic low anterior resection!

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