{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:50:51Z","timestamp":1771462251021,"version":"3.50.1"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,9,29]],"date-time":"2018-09-29T00:00:00Z","timestamp":1538179200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Mandatory splenic flexure mobilization (<jats:styled-content style=\"fixed-case\">SFM<\/jats:styled-content>) has been debated for rectal cancers. Proponents argue that additional mobilization facilitates a tension\u2010free anastomosis; however, this must be weighed against heightened morbidity. Little is known about the impact of specific techniques on pathology quality metrics. We aim to determine the impact of <jats:styled-content style=\"fixed-case\">SFM<\/jats:styled-content> on pathology quality metrics for patients undergoing rectal resections for colorectal adenocarcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Patients were selected by querying the University of Kansas electronic medical records and the American College of Surgeons National Surgical Quality Improvement Program database based on Current Procedural Terminology codes. Patients were categorized as <jats:styled-content style=\"fixed-case\">SFM<\/jats:styled-content> or non\u2010<jats:styled-content style=\"fixed-case\">SFM<\/jats:styled-content>. Primary outcomes were node yield less than 12 and margin length.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 146 patients who met the inclusion criteria for chart review and 7369 included from the national database. Splenic flexure mobilization was associated with wider margins (3.52 <jats:italic>vs<\/jats:italic> 2.51\u00a0cm in low anterior resection, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.01) and a decreased rate of inadequate nodal staging in patients undergoing low anterior resection (3.7% <jats:italic>vs<\/jats:italic> 19.3% <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">SFM<\/jats:styled-content> may affect surgical quality metrics in patients undergoing resection for distal colon and rectal adenocarcinoma. Further study is warranted to determine whether these differences in quality and pathology translate into differences in oncological outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14404","type":"journal-article","created":{"date-parts":[[2018,9,5]],"date-time":"2018-09-05T15:05:42Z","timestamp":1536159942000},"page":"23-29","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Routine splenic flexure mobilization may increase compliance with pathological quality metrics in patients undergoing low anterior resection"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2596-1222","authenticated-orcid":false,"given":"T. J.","family":"Mouw","sequence":"first","affiliation":[{"name":"Department of Surgery University of Kansas Medical Center Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"King","sequence":"additional","affiliation":[{"name":"University of Kansas School of Medicine Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. H.","family":"Ashcraft","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Kansas Medical Center Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. D.","family":"Valentino","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Kansas Medical Center Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. J.","family":"DiPasco","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Kansas Medical Center Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Al\u2010Kasspooles","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Kansas Medical Center Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,9,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588408X358774"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-008-0604-z"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-013-1049-0"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-011-0994-x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/10350-006-0811-z"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2007.01265.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v8.i3.179"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.5858\/2006-130-318-KIIRCC"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djk092"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.019313"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.11.029"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-010-1410-9"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000128172"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.14404","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.14404","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.14404","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.14404","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T11:03:31Z","timestamp":1694430211000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.14404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,29]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1111\/codi.14404"],"URL":"https:\/\/doi.org\/10.1111\/codi.14404","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,29]]},"assertion":[{"value":"2018-03-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}