Original ArticlesLaparoscopic Versus Open Resection Without Splenic Flexure Mobilization for the Treatment of Rectum and Sigmoid Cancer A Study From a Single Institution That Selectively Used Splenic Flexure MobilizationPark, Jun Seok MD*; Kang, Sung-Bum MD, PhD†; Kim, Duck-Woo MD†; Lee, Kyoung Ho MD, PhD‡; Kim, Young Hoon MD, PhD‡Author Information *Department of Surgery, College of Medicine, Chung-Ang University, Seoul Departments of †Surgery ‡Diagnostic Radiology, Seoul National University College of Medicine, Gyeonggi-do, Korea Reprints: Sung-Bum Kang, MD, PhD, Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Korea (e-mail: [email protected]). Received for publication January 27, 2008; accepted August 14, 2008 Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: February 2009 - Volume 19 - Issue 1 - p 62-68 doi: 10.1097/SLE.0b013e318196cdb0 Buy Metrics Abstract Introduction We have hypothesized that splenic flexure mobilization might be selectively undertaken in laparoscopic surgery (LAP) for rectal or sigmoid colon cancer. Patients and Methods Oncologic clearance and postoperative morbidity were compared between 119 LAP patients and 145 open surgery (OS), all of whom were treated without splenic flexure mobilization. Results The operative time was similar in the 2 groups (P>0.05). The complication rate was lower after LAP than after OS (10.0% vs. 25.5%, P=0.043). Anastomotic leakage occurred in 1 patient after LAP. On a median 29-month follow-up, the local recurrence rates did not differ significantly between the 2 groups (0.9% for LAP vs. 2.6% for OS). Conclusions Laparoscopic procedures without routine splenic flexure mobilization do not increase postoperative morbidity or oncologic risk, as compared with OS. We suggest that laparoscopic rectal and sigmoid cancer resection can be safely conducted with selective splenic flexure mobilization. © 2009 Lippincott Williams & Wilkins, Inc.