Our Summary

In this study, researchers looked at the effects of a surgical technique called splenic flexure mobilization (SFM) on the rates of complications such as leaks and infections in surgeries of the sigmoid and rectum. The sigmoid is the final part of the colon, and the rectum is the last section of the large intestine. SFM is a technique used to get better access to these areas during surgery.

They used data from previous studies to make their comparisons. They found no significant difference in the rates of leaks between patients who had SFM and those who did not. However, they found that patients who had SFM had longer surgeries and had a higher rate of infections at the surgical site. In a smaller group of patients with rectal cancer, SFM was associated with a higher rate of leaks.

In conclusion, the researchers found that SFM did not significantly reduce the rate of leaks, but was associated with a higher rate of infections. This might suggest that the technique should be used more selectively, rather than routinely, in these types of surgeries.

FAQs

  1. What is splenic flexure mobilization (SFM) and why is it used in surgery?
  2. Did the study find any significant difference between the rates of leaks in patients who had SFM and those who did not?
  3. What were the effects of SFM on surgeries related to the sigmoid and rectum in the study?

Doctor’s Tip

A doctor might tell a patient undergoing a proctectomy to ask their surgeon about the use of splenic flexure mobilization during the surgery. They could discuss the potential risks and benefits of using this technique and determine the best approach for the individual patient’s case. It is important for the patient to be informed and involved in the decision-making process regarding their surgical procedure.

Suitable For

Patients who are typically recommended for proctectomy include those with conditions such as:

  1. Colon or rectal cancer
  2. Inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease)
  3. Severe hemorrhoids
  4. Rectal prolapse
  5. Chronic constipation or fecal incontinence

It is important for patients to discuss the risks and benefits of proctectomy with their healthcare provider to determine if it is the best treatment option for their specific condition.

Timeline

Before proctectomy:

  • Patient undergoes preoperative preparations, which may include tests, imaging studies, and consultations with various healthcare providers.
  • Patient may be prescribed medications to prepare the bowel for surgery.
  • Patient may be placed on a clear liquid diet for a few days before surgery.
  • Patient undergoes the proctectomy surgery, which involves the removal of part or all of the rectum.
  • Patient may require a temporary or permanent colostomy or ileostomy, where the end of the colon or small intestine is brought to the surface of the abdomen for waste elimination.

After proctectomy:

  • Patient stays in the hospital for a few days to recover from the surgery.
  • Patient may experience pain, discomfort, and fatigue post-surgery.
  • Patient is monitored for any complications, such as leaks, infections, or blood clots.
  • Patient may be prescribed pain medications and antibiotics to manage pain and prevent infections.
  • Patient undergoes follow-up appointments with their healthcare provider to monitor their recovery and address any concerns or complications.
  • Patient may undergo physical therapy to regain strength and function in the pelvic floor muscles.
  • Patient may need to make dietary and lifestyle changes to adjust to life with a colostomy or ileostomy.

What to Ask Your Doctor

  1. What is a proctectomy and why do I need it?
  2. What are the potential risks and complications associated with a proctectomy?
  3. Are there any alternative treatment options to consider?
  4. How will the surgery be performed and what is the recovery process like?
  5. How long will I need to stay in the hospital after the surgery?
  6. What can I expect in terms of pain management and post-operative care?
  7. What are the long-term effects of a proctectomy on my bowel function and quality of life?
  8. How often will I need follow-up appointments after the surgery?
  9. Are there any specific dietary or lifestyle changes I should make after the surgery?
  10. What is the success rate of this surgery and what are the chances of complications occurring?

Reference

Authors: Gachabayov M, Bergamaschi R, Boni L, Uranues S, Fingerhut A. Journal: Surg Technol Int. 2019 May 15;34:169-182. PMID: 30574684