{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:08:47Z","timestamp":1788174527657,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T00:00:00Z","timestamp":1715904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T00:00:00Z","timestamp":1715904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Splenic flexure mobilization (SFM) is commonly performed during left\u2010sided colon and rectal resections. The aim of the present systematic review was to assess the outcomes of SFM in left\u2010sided colon and rectal resections and the risk factors for complications and anastomotic leak (AL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This study was a PRISMA\u2010compliant systematic review. PubMed, Scopus and Web of Science were searched for studies that assessed the outcomes of sigmoid and rectal resections with or without SFM. The primary outcomes were AL and total complications, and the secondary outcomes were individual complications, operating time, conversion to open surgery, length of\u00a0hospital stay (LOS) and pathological and oncological outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nineteen studies including data on 81\u2009116 patients (49.1% male) were reviewed. SFM was undertaken in 40.7% of patients. SFM was associated with a longer operating time (weighted mean difference 24.50, 95% CI 14.47\u201334.52,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and higher odds of AL (OR 1.19, 95% CI 1.06\u20131.33,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Both groups had similar odds of total complications, splenic injury, anastomotic stricture, conversion to open surgery, (LOS), local recurrence, and overall survival. A secondary analysis of rectal cancer cases only showed similar outcomes for SFM and the control group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SFM was associated with a longer operating time and higher odds of AL, yet a similar likelihood of total complications, splenic injury, anastomotic stricture, conversion to open surgery, LOS, local recurrence, and overall survival. These conclusions must be cautiously interpreted considering the numerous study limitations. SFM may have only been selectively undertaken in cases in which anastomotic tension was suspected. Therefore, the suboptimal anastomoses may have been the reason for SFM rather than the SFM being causative of the anastomotic insufficiencies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.16983","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T08:00:44Z","timestamp":1715932844000},"page":"1332-1345","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Splenic flexure mobilization in left\u2010sided colonic and rectal resections: A meta\u2010analysis and meta\u2010regression of factors associated with anastomotic leak and complications"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7854-5244","authenticated-orcid":false,"given":"Sameh Hany","family":"Emile","sequence":"first","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida 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Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Garoufalia","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Gefen","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida USA"},{"name":"Department of General Surgery, Hadassah Medical Organization and Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8046-5753","authenticated-orcid":false,"given":"Steven D.","family":"Wexner","sequence":"additional","affiliation":[{"name":"Ellen Leifer Shulman and Steven Shulman Digestive Disease Center Cleveland Clinic Florida  Weston Florida 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