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Elective laparoscopically assisted sigmoidectomy for the sigmoid volvulus.

J-T Liang1, H-S Lai, P-H Lee

  • 1Division of Colorectal Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, No.7, Chung-Shan South Road, Taipei, Taiwan, ROC. jintung@ha.mc.ntu.edu.tw

Surgical Endoscopy
|October 7, 2006
PubMed
Summary

Laparoscopic surgery for sigmoid volvulus is feasible in selected elderly patients after colonoscopic decompression. This approach offers minimized complications and faster recovery, making it a viable option for suitable candidates.

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Area of Science:

  • Minimally Invasive Surgery
  • Gastrointestinal Surgery
  • Colorectal Surgery

Background:

  • Sigmoid volvulus is a condition where the sigmoid colon twists, leading to obstruction.
  • Laparoscopic surgery for sigmoid volvulus is an uncommon indication, prompting investigation into its feasibility and outcomes.

Purpose of the Study:

  • To investigate the feasibility and surgical outcomes of elective laparoscopic surgery for sigmoid volvulus.
  • To evaluate the effectiveness of colonoscopic decompression followed by laparoscopically assisted sigmoidectomy.

Main Methods:

  • Patients underwent colonoscopic decompression for acute sigmoid volvulus.
  • Successful decompression was followed by elective laparoscopically assisted sigmoidectomy using a medial-to-lateral dissection.
  • Data on clinicopathologic features and surgical outcomes were prospectively collected.

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Main Results:

  • 14 patients (mean age 68.4 years) were treated with laparoscopic sigmoidectomy.
  • The procedure involved mobilization, exteriorization, and reconstruction of the sigmoid colon with low blood loss (44.0 mL).
  • Postoperative complications included pneumonia, myocardial infarction, and wound infection; recovery was relatively quick with a mean hospitalization of 7 days.

Conclusions:

  • Elective laparoscopic surgery after successful colonoscopic decompression is a suitable option for selected elderly and chronically ill patients with sigmoid volvulus.
  • This approach can lead to minimized surgical complications and a quicker convalescence period.