{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T08:01:53Z","timestamp":1758268913215,"version":"3.41.2"},"reference-count":22,"publisher":"FapUNIFESP (SciELO)","issue":"4","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Col. Bras. Cir."],"abstract":"<jats:p>RESUMO Objetivo: avaliar a influ\u00eancia da mobiliza\u00e7\u00e3o da flexura espl\u00eanica nos principais resultados cir\u00fargicos de pacientes submetidos \u00e0 ressec\u00e7\u00e3o de c\u00e2ncer do c\u00f3lon sigmoide ou reto. M\u00e9todos: os bancos de dados MEDLINE, Cochrane Central Register de Ensaios Controlados e LILACS foram pesquisados usando os termos \"mobiliza\u00e7\u00e3o da flexura espl\u00eanica\", \"cirurgia colorretal\", \"c\u00e2ncer retal\", \"ressec\u00e7\u00e3o anterior\", \"c\u00e2ncer de c\u00f3lon sigmoide\", \"ressec\u00e7\u00e3o de sigmoide\". O desfecho principal foi a deisc\u00eancia da anastomose. Outros desfechos analisados foram mortalidade, sangramento, infec\u00e7\u00e3o e complica\u00e7\u00f5es gerais. Os tamanhos dos efeitos foram estimados por meio do agrupamento dos dados de seis estudos de caso-controle (1.433 pacientes) publicados at\u00e9 janeiro de 2018. Resultados: nossa meta-an\u00e1lise revelou que pacientes submetidos \u00e0 mobiliza\u00e7\u00e3o completa da flexura espl\u00eanica tinham um risco maior de deisc\u00eancia anastom\u00f3tica (RR=2,27, IC95%: 1,22-4,23) em compara\u00e7\u00e3o \u00e0queles n\u00e3o submetidos a esse procedimento. Nenhuma diferen\u00e7a p\u00f4de ser demonstrada entre os grupos em termos de mortalidade, sangramento, infec\u00e7\u00e3o e complica\u00e7\u00f5es gerais. Conclus\u00e3o: a mobiliza\u00e7\u00e3o da flexura espl\u00eanica est\u00e1 associada a um maior risco de deisc\u00eancia anastom\u00f3tica nas ressec\u00e7\u00f5es de c\u00e2ncer de reto ou c\u00f3lon sigmoide. Esta manobra cir\u00fargica deve ser utilizada com cautela no manejo cir\u00fargico dos tumores colorretais.<\/jats:p>","DOI":"10.1590\/0100-6991e-20192171","type":"journal-article","created":{"date-parts":[[2019,10,17]],"date-time":"2019-10-17T22:35:27Z","timestamp":1571351727000},"source":"Crossref","is-referenced-by-count":10,"title":["Mobiliza\u00e7\u00e3o da flexura espl\u00eanica nas ressec\u00e7\u00f5es dos tumores de reto e sigmoide: meta-an\u00e1lise dos resultados cir\u00fargicos."],"prefix":"10.1590","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5031-3409","authenticated-orcid":false,"given":"Daniel C.","family":"Damin","sequence":"first","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Brazil; Universidade Federal do Rio Grande do Sul, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luize N.","family":"Betanzo","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Brazil; Universidade Federal do Rio Grande do Sul, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patr\u00edcia K.","family":"Ziegelmann","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2019]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1002\/bjs.1800691019","article-title":"The mesorectum in rectal cancer surgery--the clue to pelvic recurrence?","volume":"69","author":"Heald RJ","year":"1982","journal-title":"Br J Surg"},{"issue":"5","key":"ref2","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1097\/DCR.0b013e31828cb66c","article-title":"Practice parameters for the management of rectal cancer (revised)","volume":"56","author":"Monson JR","year":"2013","journal-title":"Dis Colon Rectum"},{"issue":"8","key":"ref3","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1308\/003588408X358774","article-title":"Controversial topics in surgery: splenic flexure mobilisation for anterior resection performed for sigmoid and rectal cancer","volume":"90","author":"Kennedy R","year":"2008","journal-title":"Ann R Coll Surg Engl"},{"issue":"4","key":"ref4","doi-asserted-by":"crossref","first-page":"264","DOI":"10.7326\/0003-4819-151-4-200908180-00135","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"151","author":"Moher D","year":"2009","journal-title":"Ann Intern Med"},{"year":"2012","series-title":"Use of mixed treatment comparisons in systematic reviews [Internet]","author":"Coleman CI Phung OJ","key":"ref5"},{"issue":"3","key":"ref6","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1007\/10350-006-0811-z","article-title":"Routine mobilization of the splenic flexure is not necessary during anterior resection for rectal cancer","volume":"50","author":"Brennan DJ","year":"2007","journal-title":"Dis Colon Rectum"},{"issue":"2","key":"ref7","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1111\/j.1463-1318.2007.01265.x","article-title":"A 6-year review of surgical morbidity and oncological outcome after high anterior resection for colorectal malignancy with and without splenic flexure mobilization","volume":"10","author":"Katory M","year":"2008","journal-title":"Colorectal Dis"},{"issue":"10","key":"ref8","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1111\/j.1463-1318.2011.02927.x","article-title":"The selective use of splenic flexure mobilization is safe in both laparoscopic and open anterior resections","volume":"14","author":"Marsden MR","year":"2012","journal-title":"Colorectal Dis"},{"issue":"4","key":"ref9","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1089\/lap.2011.0409","article-title":"Complete versus partial mobilization of splenic flexure during laparoscopic low anterior resection for rectal tumors: a comparative study","volume":"22","author":"Gezen C","year":"2012","journal-title":"J Laparoendosc Adv Surg Tech A"},{"issue":"12","key":"ref10","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1177\/000313481307901226","article-title":"Is routine splenic flexure mobilization always mandatory for left colectomy? 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