Laparoscopic Splenic Flexure Mobilization

Study Overview
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Brief Summary
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This retrospective cohort study conducted on 140 patients who underwent laparoscopic anterior resection for upper rectal cancer in the period from May 2011 to November 2015, comparison will be done on splenic flexure mobilization excluding .

Detailed Description
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Presently, it is acknowledged that laparoscopic colectomy for left sided colorectal cancer is the most common surgery operated in laparoscopic colorectal surgeries, However the most debatable question in such type of operations that is it mandatory to do splenic flexure mobilization or not? In the literatures colorectal surgeons divided into 2 teams, those with splenic flexure mobilization in laparoscopic left colorectal resection to have tension free, well vascularized anastomosis On the other hand those against splenic flexure mobilization reported that omitting this step does not significantly affect the leakage rate, morbidity or the oncological outcomes In this study, we evaluate the necessity of splenic flexure mobilization in laparoscopic anterior resection for upper rectal tumors and its impact on the operative time, total morbidity, leakage rate, oncological safety and continence level

Official Title
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Is it Necessary to do Splenic Flexure Mobilization in Laparoscopic Resection of Upper Rectal Tumors?

Conditions
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Splenic Flexure Mobilization

Intervention / Treatment
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* Procedure: Laparoscopic high anterior resection splenic flexure mobilization
* Procedure: Laparoscopic high anterior resection without splenic flexure mobilization


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with upper rectal tumors. Exclusion Criteria: Low and mid rectal cancer Splenic flexure tumors, descending colon cancer, patients with associated lesions in the right or transverse colon Emergency cases.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Mobilization group<br>Laparoscopic splenic flexure mobilization will be done. | Procedure: Laparoscopic high anterior resection splenic flexure mobilization<br> <br> |
| Active Comparator: Non mobilization group<br>No mobilization of splenic flexure. | Procedure: Laparoscopic high anterior resection without splenic flexure mobilization<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the incidence of leakage rate in laparoscopic anterior resection with splenic flexure mobilization versus non mobilization of splenic flexure |  | One year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Laparoscopic colectomy., Splenic flexure mobilization., Anastomotic leakage.