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The management of sigmoid volvulus
1Department of Surgery, University of Natal, Durban, South Africa.
Journal of the Royal College of Surgeons of Edinburgh
|May 24, 2000
Summary
Sigmoid volvulus management varies, especially for viable colon after an episode. Advances in minimally invasive techniques necessitate a re-evaluation of non-resectional treatment options for this condition.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Clinical Medicine
Background:
- Sigmoid volvulus is a well-defined condition with established epidemiology and clinical presentation.
- Acute sigmoid volvulus often presents clearly, but diagnostic challenges can arise.
- Supervening gangrene significantly increases mortality rates.
Purpose of the Study:
- To critically reappraise management options for viable colon following sigmoid volvulus.
- To evaluate the impact of minimally invasive techniques on treatment strategies.
- To provide updated guidance on non-resectional alternatives for sigmoid volvulus.
Main Methods:
- Review of epidemiological data and clinical patterns of sigmoid volvulus.
- Analysis of diagnostic challenges and outcomes associated with gangrene.
- Assessment of current and emerging surgical techniques for viable colon management.
Main Results:
- Gangrene necessitates immediate resectional surgery.
- Multiple management options exist for viable colon after volvulus.
- Non-resectional approaches require further critical evaluation.
Conclusions:
- While gangrene dictates resection, viable colon management offers alternatives.
- Minimally invasive techniques may influence the choice of non-resectional treatments.
- Further reappraisal of non-resectional strategies for sigmoid volvulus is warranted.