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- W2964591637 abstract "Background Despite a lack of supporting data, routine splenic flexure mobilization (SFM) during colectomy has been thought to reduce anastomotic leak (AL). We evaluated the impact of SFM on outcomes in distal colectomy. Study design The 2005–2016 NSQIP database identified 66,068 patients undergoing distal colectomy with anastomosis. Cohorts were stratified by addition of SFM. Postoperative outcomes were compared between groups. Regression analysis identified factors affecting odds of developing AL. Results SFM was performed in 27,475 patients (41.6%). There was no difference in overall complications between cases with SFM and those without (p = 0.55). SFM had longer operative times (220 min vs. 184 min; p < 0.0001). SFM was not associated with any difference in AL rate (3.6% vs. 3.7%; p = 0.86). Factors most associated with AL were lack of oral antibiotic preparation (OR 1.93; p < 0.001), chemotherapy (OR 1.91; p < 0.001), and weight loss (OR 1.68; p = 0.0005). Operative indication and approach did not affect leak. Conclusions SFM in distal colectomy increased operative time without decreasing overall complications or AL. Routine splenic flexure mobilization may add risk without significant benefit." @default.
- W2964591637 created "2019-08-13" @default.
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- W2964591637 date "2020-06-01" @default.
- W2964591637 modified "2023-10-01" @default.
- W2964591637 title "Examining Utility of Routine Splenic Flexure Mobilization during Colectomy and Impact on Anastomotic Complications" @default.
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- W2964591637 doi "https://doi.org/10.1016/j.amjsurg.2019.07.030" @default.
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