Recurrence of sigmoid volvulus after surgical intervention

Little attention has been focused on the recurrence rate of sigmoid volvulus after surgical therapy. Consequently, we reviewed the longterm post-operative course of 29 patients who underwent surgery for sigmoid volvulus. The overall recurrence rate was 36 per cent, with recurrences occurring in 7 of 19 patients who underwent sigmoid colectomy and anastomosis; 1 of 5 patients undergoing sigmoid colectomy and end colostomy; and 2 of 4 patients undergoing laparotomy without resection. Although the recurrence rate varied slightly according to the operative procedure performed, the major variable was the degree of colonic involvement, since patients whose disease was limited to the sigmoid colon had a 6 per cent recurrence rate compared to 82 per cent for those with associated megacolon (p = .005). In patients with megacolon treated by subtotal colectomy, no recurrences were documented. Therefore, subtotal colectomy should be considered as the surgical procedure of choice in patients with sigmoid volvulus with associated megacolon.