[Assessment of the efficiency and safety of the modified combined approach for laparoscopic splenic flexure...

To evaluate the efficacy and safety of the proposed modified combined approach for laparoscopic splenic flexure mobilization (SFM).

A multicenter non-randomized comparative study was conducted. The main group consisted of 12 patients who underwent laparoscopic modified combined SFM from December 2018 to May 2019, the control group consisted of 12 patients who underwent laparoscopic traditional combined SFM from 2013 to 2018. The following aspects were evaluated: total duration of the operation, duration of the SFM, blood loss, rate of conversions, intraoperative complications, postoperative complications, duration of the postoperative period.

Significant differences were obtained for the average duration of the SFM. The duration of the procedure was calculated during watching a video of operation. The average duration of the SFM in the main group was 37.4±12.2 min, in the control group 59.5±19.1 min (p=0.03). The average blood loss in the main group was 52.5±12.3 ml, in the control group - 115.6±20.7 ml (p=0.02). In the main group there were no intraoperative complications, while in the comparison group 1 case of the spleen damage was noted, requiring conversion, and 1 case of the pancreas damage. These differences are not significant due to the small sample.

The use of the proposed modified combined approach for the laparoscopic SFM significantly reduces the duration of the operation and is accompanied by a decrease in the frequency of intraoperative complications. However, further randomized studies with a larger sample are needed.