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[Operative mortality in sigmoid volvulus]

J Díaz-Plasencia1, C Sánchez, M Bardales

  • 1Departamento de Cirugía del Hospital Belén de Trujillo.

Revista De Gastroenterologia Del Peru : Organo Oficial De La Sociedad De Gastroenterologia Del Peru
|January 1, 1993
PubMed
Summary
This summary is machine-generated.

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Sigmoid volvulus surgery outcomes reveal age over 40, low mean arterial pressure, and gangrenous colon with perforation significantly increase operative mortality risk. Careful patient assessment is crucial for better therapeutic choices.

Area of Science:

  • Gastroenterology
  • Surgical Outcomes
  • Prognostic Factor Analysis

Context:

  • Retrospective analysis of 123 patients with sigmoid volvulus undergoing surgery.
  • Data collected from Belen Hospital, Trujillo, Peru, between 1967 and 1992.
  • Focus on identifying prognostic factors for operative mortality.

Purpose:

  • To identify factors influencing operative mortality in sigmoid volvulus patients.
  • To evaluate the prognostic value of various clinical and surgical parameters.
  • To inform therapeutic strategies by understanding risk factors.

Summary:

  • Surgical techniques evaluated: detorsion with colopexy (0% mortality), resection with anastomosis (13% mortality), and resection with colostomy (31.4% mortality).
  • Key mortality predictors identified: age > 40, mean arterial pressure < 70 mmHg, purulent/fecaloid peritoneal fluid, and gangrenous colon with perforation.

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  • No significant mortality differences noted for sex, duration of obstruction, or leukocyte count.

    • Impact:

    • Highlights critical risk factors (age, hemodynamic status, peritoneal contamination, bowel viability) impacting sigmoid volvulus surgical outcomes.
    • Emphasizes the need for incorporating these prognostic indicators into clinical decision-making for improved patient management.
    • Provides valuable insights for surgical planning and risk stratification in sigmoid volvulus cases.