Examining Utility of Routine Splenic Flexure Mobilization during Colectomy and Impact on Anastomotic Complications

Examining Utility of Routine Splenic Flexure Mobilization during Colectomy and Impact on Anastomotic Complications

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. The 2005–2016 NSQIP database identified 66,068 patients undergoing distal colectomy with an...

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Veröffentlicht in:The American journal of surgery 2020-06, Vol.219 (6), p.998-1005
Hauptverfasser: Dilday, Joshua C., Gilligan, Timothy C., Merritt, Clay M., Nelson, Daniel W., Walker, Avery S.
Format: Artikel
Sprache:eng
Schlagworte:
Anastomosis
Anastomotic leak
Antibiotics
Cancer
Chemotherapy
Cohort analysis
Colectomy
Complications
Datasets
Diabetes
Hemodialysis
Hypertension
Infections
Intubation
Laparoscopy
Morbidity
Mortality
Pneumonia
Regression analysis
Sepsis
Spleen
Splenic flexure mobilization
Surgeons
Thrombosis
Ventilators
Weight loss
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Zusammenfassung: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. 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. 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 
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2019.07.030