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Updated: Apr 15, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
What are the results of colonic volvulus surgery?
Kevin R Kasten1, Peter W Marcello, Patricia L Roberts
1Department of Colorectal Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts.
Insights
Operative outcomes for colonic volvulus vary by procedure. While resectional surgery is common, intraoperative manipulation/fixation may offer initial benefits but carries a higher risk of reoperation.
Area of Science:
- Gastroenterology
- Surgical Outcomes Research
- Colorectal Surgery
Background:
- Operative results for colonic volvulus are not well-documented due to infrequent diagnosis.
- Understanding surgical outcomes is crucial for managing this condition.
Purpose of the Study:
- To investigate the outcomes of different surgical interventions for colonic volvulus.
- To compare the risks and benefits associated with various surgical procedures.
Main Methods:
- Utilized California Inpatient Database and Supplemental Files for Revisit Analyses (2005-2007).
- Identified 2141 patients undergoing manipulation/fixation, right colectomy, left colectomy, or total colectomy for colonic volvulus.
- Analyzed recurrence risk, reoperation rates, stoma formation, discharge disposition, and in-hospital mortality.
Main Results:
- Total colectomy had the highest mortality (21%), stoma creation (64%), and longest hospital stay (18 days).
- Intraoperative manipulation/fixation showed the lowest mortality and stoma rates but the highest risk of subsequent procedures (26%).
- Patients undergoing manipulation/fixation were younger, more likely female, and had private insurance.
Conclusions:
- Most colonic volvulus patients undergo resectional surgery.
- Non-resectional approaches (manipulation/fixation) yield favorable initial results but increase the risk of future operations.
- Intraoperative manipulation/fixation may be a viable option for select colonic volvulus patients.
Background:
Operative results of volvulus are largely unknown because of infrequent diagnosis.
Objective:
We examined the results of operative intervention for colonic volvulus.
Design:
We merged trackable data from the California Inpatient Database with Supplemental Files for Revisit Analyses between January 1, 2005, and December 31, 2007.
Settings:
Trackable data from California discharge records.
Patients:
We identified all of the patients with colonic volvulus who underwent 1 of 4 surgical procedures, including manipulation/fixation of the colon, right colectomy, left colectomy, or total colectomy.
Main Outcome Measures:
During the 36-month study period, we identified recurrence risk, recurrence requiring reoperation, time to reoperation, stoma formation, disposition on discharge, and in-hospital mortality. Fisher exact, χ(2), and ANOVA tests were used when appropriate.
Results:
We identified 2141 patients with colonic volvulus who were undergoing intraoperative manipulation/fixation of the colon (n = 209 (12%)), right (n = 728 (41%)), left (n = 781 (44%)), or total colectomy (n = 56 (3%)). Patients treated with intraoperative manipulation/fixation were younger, more likely to be women, and more likely to have private insurance. Patients who underwent total colectomy had the highest risk of mortality (21%), highest risk of stoma creation (64%), and longest length of stay (18 days); were more likely to be readmitted (9%); and were the most likely to be discharged to a skilled nursing facility (48%). Patients treated with intraoperative manipulation/fixation had the lowest mortality, risk of stoma formation, length of stay, and likelihood of discharge to skilled nursing facility but the highest risk of subsequent procedures for volvulus (26%) over a follow-up ranging from 0 to 687 days.
Limitations:
This study was limited by retrospective study design, heterogeneous patient factors, and inability to identify the time of last follow-up.
Conclusions:
The majority of patients with volvulus underwent a resectional procedure. A subset without resection had favorable initial outcomes but remained at high risk for subsequent procedures. There may be a potential role for evaluating intraoperative manipulation/fixation in a small subset of patients with colonic volvulus.
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