ArticleBJS open2021
Classification of the colonic splenic flexure based on three-dimensional CT analysis.
Article in BJS open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Predictors of difficulty in robotic splenic flexure mobilization during rectal cancer surgery.International journal of colorectal disease · 2025Article
- Splenic flexure mobilization: does body topography matter?Techniques in coloproctology · 2024Article
- Moderate Splenic Injury Caused by Colonoscopy.Internal medicine (Tokyo, Japan) · 2024Article
- Uptake of robot-assisted colon cancer surgery in the Netherlands.Surgical endoscopy · 2023Article
- Predictors for selective flexure mobilization during robotic anterior resection for rectal cancer: a prospective cohort analysis.Surgical endoscopy · 2023Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMobilization of the splenic flexure can be a challenging surgical step in colorectal surgery. This study aimed to classify the splenic flexure based on the three-dimensional (3D) coordinates of the splenic hilum and left renal hilum. This classification was used to compare splenic flexure mobilization during colorectal resection.
methodsCT images of patients with colorectal cancer treated between April 2018 and December 2019 were analysed retrospectively. 3D mutual positioning of the splenic flexure from the ligament of Treitz to the splenic hilum or the left renal hilum was used to classify patients into three groups using cluster analysis. The difference in the procedure time between groups was also analysed in a subset of patients undergoing laparoscopic colectomy with complete splenic flexure mobilization.
resultsOf 515 patients reviewed, 319 with colorectal cancers were included in the study and categorized based on the 3D coordinates of the splenic hilum and left renal hilum as caudal (100 patients), cranial (118) and lateral (101) positions. Male sex (P < 0.001), older age (P = 0.004) and increased bodyweight (P = 0.043) were independent characteristics of the lateral group in multiple logistic regression analysis. Thirty-four patients underwent complete splenic flexure mobilization during the study period; this took significantly longer (mean 78.7 min) in the lateral group than in the caudal and cranial groups (41.8 and 43.2 min respectively; P = 0.006).
conclusionLocating the splenic flexure using 3D coordinates could be helpful in predicting a longer duration for mobilization of the splenic flexure.
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