Operative therapy for cecal volvulus combining resection with colopexy

Area of Science:

• Gastroenterology
• Surgical Oncology
• Abdominal Surgery

Background:

• Cecal volvulus is a rare cause of bowel obstruction.
• Existing treatment options for cecal volvulus yield variable results.
• This study addresses the need for effective surgical management of cecal volvulus.

Purpose of the Study:

• To evaluate a uniform surgical resection technique for cecal volvulus.
• To assess the safety and efficacy of avoiding detorsion and reperfusion in cecal volvulus surgery.
• To determine the recurrence rate of cecal volvulus following this specific surgical approach.

Main Methods:

• A retrospective review of 10 consecutive cecal volvulus patients treated with resection without detorsion.
• Surgical technique involved stapled resection, anastomosis of ileum to right colon remnant, and colopexy.
• Patients received complete clinical follow-up to assess outcomes and recurrence.

Main Results:

• All 10 patients survived the surgery and were discharged.
• Five patients presented with gangrene, and two had perforation; all survived.
• No recurrence of cecal volvulus was observed in any patient during follow-up.
• Postoperative complications included bleeding, pneumonia, and wound infection.

Conclusions:

• A uniform resection procedure for cecal volvulus, avoiding reperfusion, is safe and effective.
• Colopexy of the right colon remnant successfully prevented recurrence.
• This approach may mitigate risks associated with reperfusion injury in ischemic bowel.