Colorectal Cancer: Open Access

The Safety and Efficacy of Selective use of Splenic Flexure Mobilization in Rectal Cancer Surgery-Experience from a Tertiary Hospital

Introduction: Splenic Flexure Mobilization (SFM) is widely considered to be an essential component of anterior resection of rectal cancer to achieve a tension-free anastomosis. No local studies have compared outcomes with and without SFM in laparoscopic and open colorectal cancer surgery.

Objectives: This study aimed to determine whether routine or selective SFM should be advised.

Method: From a prospective database, all patients who had undergone elective anterior resection for colorectal cancer between 2011-2016 were identified Demographics, operative details, morbidity, mortality and pathology for patients with and without SFM were analysed.

Results: Of the 249 resections, there were no clinicopathologic difference between those who had SFM (n=56) and those who did not (n=193). Mean operative time in SFM group was longer (279 min) vs. (230 min) (p=0.034). There was no difference in age, gender, ASA score, length of stay, lymph node yield and conversion rate. No statistical significant difference was found for lymph node harvest (p=0.544), postoperative morbidity (p=0.107), reoperation (p=0.384) and 30-day mortality (p=0.610).

Conclusion: Our results show no morbidity and oncological disadvantage when SFM was avoided. SFM takes longer. A selective approach to SFM is safe during anterior resection.

Author(s): Siu Yan Kok

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