Assessing the extent of colon lengthening due to splenic flexure mobilization techniques: a cadaver study


Autoria(s): Araujo, Sergio Eduardo Alonso; Seid, Victor Edmond; Kim, Nam Jin; Bertoncini, Alexandre Bruno; Nahas, Sergio Carlos; Cecconello, Ivan
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

04/11/2013

04/11/2013

2012

Resumo

CONTEXT: Failure of a colorectal anastomosis represents a life-threatening complication of colorectal surgery. Splenic flexure mobilization may contribute to reduce the occurrence of anastomotic complications due to technical flaws. There are no published reports measuring the impact of splenic flexure mobilization on the length of mobilized colon viable to construct a safe colorectal anastomosis. OBJECTIVE: The aim of the present study was to determine the effect of two techniques for splenic flexure mobilization on colon lengthening during open left-sided colon surgery using a cadaver model. DESIGN: Anatomical dissections for left colectomy and colorectal anastomosis at the sacral promontory level were conducted in 20 fresh cadavers by the same team of four surgeons. The effect of partial and full splenic flexure mobilization on the extent of mobilized left colon segment was determined. SETTING: University of Sao Paulo Medical School, Sao Paulo, SP, Brazil. Tertiary medical institution and university hospital. PARTICIPANTS: A team of four surgeons operated on 20 fresh cadavers. RESULTS: The length of resected left colon enabling a tension-free colorectal anastomosis at the level of sacral promontory achieved without mobilizing the splenic flexure was 46.3 (35-81) cm. After partial mobilization of the splenic flexure, an additionally mobilized colon segment measuring 10.7 (2-30) cm was obtained. After full mobilization of the distal transverse colon, a mean 28.3 (10-65) cm segment was achieved. CONCLUSION: Splenic flexure mobilization techniques are associated to effective left colon lengthening for colorectal anastomosis. This result may contribute to decision-making during rectal surgery and low colorectal and coloanal anastomosis.

Identificador

Arq. Gastroenterol.,v.49,n.3,p.219-222,2012

0004-2803

http://www.producao.usp.br/handle/BDPI/38082

10.1590/S0004-28032012000300010

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032012000300010&lng=en&nrm=iso&tlng=en

http://www.scielo.br/scielo.php?script=sci_abstract&pid=S0004-28032012000300010&lng=en&nrm=iso&tlng=en

http://www.scielo.br/scielo.php?script=sci_pdf&pid=S0004-28032012000300010&lng=en&nrm=iso&tlng=en

Idioma(s)

eng

Publicador

Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED

Relação

Arquivos de Gastroenterologia

Direitos

openAccess

Palavras-Chave #Colectomy #Colon, transverse #Rectal neoplasms #Cadaver #Colectomia #Cólon transverso #Neoplasias retais #Cadáver
Tipo

article

original article