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Sigmoid volvulus: study from a north Indian hospital
A K Khanna1, P Kumar, R Khanna
1Department of Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Diseases of the Colon and Rectum
|August 24, 1999
Summary
Surgical resection and extraperitonealization are effective treatments for sigmoid volvulus, avoiding high recurrence rates seen with colocolopexy. This study compares surgical options for sigmoid volvulus management.
Area of Science:
- Gastroenterology
- Surgical Procedures
- Colorectal Surgery
Background:
- Sigmoid volvulus is a common cause of large bowel obstruction, particularly in certain geographic regions.
- Timely diagnosis and appropriate surgical intervention are crucial for favorable outcomes.
Purpose of the Study:
- To review surgical experiences with sigmoid volvulus.
- To compare the efficacy of different surgical procedures for sigmoid volvulus treatment.
Main Methods:
- Retrospective analysis of 111 patients with sigmoid volvulus over six years.
- Surgical procedures included bowel resection, colocolopexy, and extraperitonealization.
- Patient demographics, symptom duration, diagnostic methods, and outcomes were recorded.
Main Results:
- Plain abdominal radiographs diagnosed 68.47% of cases.
- Resection was performed in 46 patients (40 gangrenous, 6 viable).
- Nonresectional procedures included colocolopexy (13 patients) and extraperitonealization (44 patients).
- Mortality rate was 6.3%.
- Recurrence rates were 0% for resection and extraperitonealization, versus 38.5% for colocolopexy.
Conclusions:
- Resection and extraperitonealization are suitable for nongangrenous sigmoid volvulus.
- Colocolopexy is associated with a high recurrence rate and is not recommended.
- Surgical management should prioritize procedures with lower recurrence rates.