ArticleJournal of clinical medicine2018
The Safety of Selective Use of Splenic Flexure Mobilization in Sigmoid and Rectal Resections-Systematic Review and Meta-Analysis.
Article in Journal of clinical medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Is routine splenic flexure mobilization always necessary in laparotomic or laparoscopic anterior rectal resection? A systematic review and comprehensive meta-analysis.Updates in surgery · 2021Pooled it
- A Meta-analysis of Powered Circular StaplerIn vivo (Athens, Greece)Pooled it
- Comment on "Minimally invasive surgery for diverticulitis: a single-center retrospective study in the United States focusing on splenic flexure mobilization in elective sigmoid colectomy".Journal of minimally invasive surgery · 2026Article
- Laparoscopic Sigmoid Colectomy in a Patient With Congenital Left Renal Agenesis: A Case Report.Cureus · 2026Article
- Minimally invasive surgery for diverticulitis: a single-center retrospective study in the United States focusing on splenic flexure mobilization in elective sigmoid colectomy.Journal of minimally invasive surgery · 2026Article
- Oncological and Clinical Impacts of Routine Splenic Flexure Mobilization in Anterior Resection.Cureus · 2024Article
- Surgical considerations for the "perfect" colorectal anastomosis.Journal of gastrointestinal oncology · 2023Review
- Predictors for selective flexure mobilization during robotic anterior resection for rectal cancer: a prospective cohort analysis.Surgical endoscopy · 2023Article
- Article
- The Colorectal Anastomosis: A Timeless Challenge.Clinics in colon and rectal surgery · 2023Review
- Prevention of anastomotic leakage using a polyglycolic acid sheet in double-stapling technique anastomosis for rectal surgery.Annals of medicine and surgery (2012) · 2021Article
- Review of Colonic Anastomotic Leakage and Prevention Methods.Journal of clinical medicine · 2020Review
- Impact of intraoperative indocyanine green fluorescence angiography on anastomotic leakage after laparoscopic sphincter-sparing surgery for malignant rectal tumors.International journal of colorectal disease · 2020Article
- Effect of splenic flexure mobilization performed via medial-to-lateral and superior-to-inferior approach on early clinical outcomes in elective laparoscopic resection of rectal cancer.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2019Article
- Impact of Circular Stapler Size on the Risk of Anastomotic Complications in Patients With Left-sided Colorectal Cancer: A Propensity Score-matched Study.Cancer diagnosis & prognosisArticle
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccording to traditional textbooks on surgery, splenic flexure mobilization is suggested as a mandatory part of open rectal resection. However, its use in minimally invasive access seems to be limited. This stage of the procedure is considered difficult in the laparoscopic approach. The aim of this study was to systematically review literature on flexure mobilization and perform meta-analysis.
methodsA systematic review of the literature was performed using the Medline, Embase and Scopus databases to identify all eligible studies that compared patients undergoing rectal or sigmoid resection with or without splenic flexure mobilization. INCLUSION CRITERIA: (1) comparison of groups of patients with and without mobilization and (2) reports on overall morbidity, anastomotic leakage, operative time, length of specimen, number of harvested lymph nodes, or length of hospital stay. The outcomes of interest were: operative time, conversion rate, number of lymph nodes harvested, overall morbidity, mortality, leakage rate, reoperation rate, and length of stay.
resultsInitial search yielded 2282 studies. In the end, we included 10 studies in the meta-analysis. Splenic flexure is associated with longer operative time (95% confidence interval (CI) 23.61⁻41.25;
conclusionsNot mobilizing the splenic flexure results in a significantly shorter operative time and a longer length of stay. Further research is required to establish whether flexure mobilization is required in minimally invasive surgery.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.