[Operative mortality in sigmoid volvulus]

This retrospective analysis evaluated 123 patients with sigmoid volvulus that underwent surgery at the Belen Hospital, Trujillo, Peru, from January 1, 1967 to December 31, 1992 in an attempt to identify by univariate analysis factors of prognostic value of operative mortality. The surgical procedures performed were destortion plus colopexia (n = 19), intestinal resection with primary anastomosis (n = 69) and resection plus colostomy (n = 35) with an operative death rate of 0%, 13% and 31.4% respectively (p = 0.005). The overall operative mortality rate was of 19.4%. The following parameters were evaluated: age, sex, duration of obstruction, mean arterial pressure, leukocyte count, type of peritoneal fluid, state of the bowel and surgical technique. Analysis of post-operative mortality disclosed the following factors associated with increased mortality: age older than 40 (p = 0.008), mean arterial pressure lower than 70 mmHg (p = 0.0001), presence of purulent or fecaloid peritoneal fluid (p = 0.001) and evidence of gangrenous colon with perforation (p = 0.0001). There were no statistically significant differences in mortality rate with regard to sex, length of history and leukocyte count. Therefore, we emphasize the need to take into account these risk factors to better clarify appropriate therapy options.