Surgical management of sigmoid volvulus: A multicenter observational study

Keunchul Lee, Heung Kwon Oh, Jung Rae Cho, Minhyun Kim, Duck Woo Kim, Sung Bum Kang, Hyung Jin Kim, Hyoung Chul Park, Rumi Shin, Seung Chul Heo, Seung Bum Ryoo, Kyu Joo Park

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Abstract

Purpose: This study aimed to evaluate real-world clinical outcomes from surgically treated patients for sigmoid volvulus. Methods: Five tertiary centers participated in this retrospective study with data collected from October 2003 through September 2018, including demographic information, preoperative clinical data, and information on laparoscopic/open and elective/emergency procedures. Outcome measurements included operation time, postoperative hospitalization, and postoperative morbidity. Results: Among 74 patients, sigmoidectomy was the most common procedure (n=46), followed by Hartmann's procedure (n=23), and subtotal colectomy (n=5). Emergency surgery was performed in 35 cases (47.3%). Of the 35 emergency pa-tients, 34 cases (97.1%) underwent open surgery, and a stoma was established for 26 patients (74.3%). Elective surgery was performed in 39 cases (52.7%), including 21 open procedures (53.8%), and 18 laparoscopic surgeries (46.2%). Median laparoscopic operation time was 180 minutes, while median open surgery time was 130 minutes (P<0.001). Median postoperative hospitalization was 11 days for laparoscopy and 12 days for open surgery. There were 20 postoperative complications (27.0%), and all were resolved with conservative management. Emergency surgery cases had a higher complication rate than elective surgery cases (40.0% vs. 15.4%, P=0.034). Conclusion: Relative to elective surgery, emergency surgery had a higher rate of postoperative complications, open surgery, and stoma formation. As such, elective laparoscopic surgery after successful sigmoidoscopic decompression may be the optimal clinical option.

Original languageEnglish
Pages (from-to)403-408
Number of pages6
JournalAnnals of Coloproctology
Volume36
Issue number6
DOIs
StatePublished - 31 Dec 2021

Keywords

  • Elective surgery
  • Laparoscopy
  • Sigmoid volvulus

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