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Mobilização da flexura esplênica nas ressecções dos tumores de reto e sigmoide: meta-análise dos resultados cirúrgicos. / Mobilização da flexura esplênica nas ressecções dos tumores de reto e sigmoide: meta-análise dos resultados cirúrgicos. / Splenic flexure mobilization in sigmoid and rectal cancer resections: a meta-analysis of surgical outcomes.
Rev Col Bras Cir ; 46(4): e20192171, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31644719
RESUMO

OBJECTIVE:

to evaluate the influence of the splenic flexure mobilization for the main surgical outcomes of patients submitted to resection of sigmoid and rectal cancer.

METHODS:

we searched the MEDLINE, Cochrane Central Register of Controlled Trials and LILACS, using the terms "splenic flexure mobilization", "colorectal surgery", "rectal cancer", "anterior resection", "sigmoid colon cancer", and "sigmoid resection". The main outcome was anastomotic dehiscence. Other outcomes analyzed were mortality, bleeding, infection and general complications. We estimated the effect sizes by grouping data from six case-control studies (1,433 patients) published until January 2018.

RESULTS:

our meta-analysis showed that patients undergoing complete mobilization of the splenic flexure had a higher risk of anastomotic dehiscence (RR=2.27, 95%CI: 1.22-4.23) compared with those not submitted to this procedure. There was no difference between the groups in terms of mortality, bleeding, infection and general complications.

CONCLUSION:

splenic flexure mobilization is associated with a higher risk of anastomotic dehiscence in resections of sigmoid and rectal cancer. This surgical maneuver should be used with caution in the surgical management of sigmoid or rectal cancers.
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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Neoplasias Retais / Neoplasias do Colo Sigmoide / Colectomia / Protectomia Tipo de estudo: Revisão sistemática Aspecto clínico: Etiologia Limite: Humanos Idioma: Inglês / Português Revista: Rev Col Bras Cir Ano de publicação: 2019 Tipo de documento: Artigo País de afiliação: Brasil