A K Khanna1, P Kumar, R Khanna. 1. Department of Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Abstract
PURPOSE: The aim of this study was to review our experience with sigmoid volvulus and to compare the various surgical procedures performed for treatment of sigmoid volvulus. METHODS: A retrospective study of 111 patients with sigmoid volvulus treated at University Hospital in northern India during last six years was performed. RESULTS: Mean age for sigmoid volvulus was 51.1 +/- 15.3 years, with a male-to-female ratio of 2.5:1. Duration of symptoms was 4.3 +/- 2.6 days. Plain radiographs of the abdomen suggested the diagnosis in 76 cases (68.47 percent). Resection of the bowel was performed in 40 cases with gangrenous sigmoid colon and 6 cases with viable colon. Nonresectional procedure in the form of colocolopexy (fixation of sigmoid to transverse colon) or extraperitonealization was performed in 13 and 44 cases, respectively. Mortality was 6.3 percent (n = 7). No recurrence was seen after resection and extraperitonealization, whereas 5 of 13 cases (38.5 percent) had recurrence after colocolopexy. CONCLUSION: Resection and extraperitonealization of the sigmoid colon are the suitable alternatives for nongangrenous sigmoid volvulus. Colocolopexy is not indicated, because of the associated high recurrence rate.
PURPOSE: The aim of this study was to review our experience with sigmoid volvulus and to compare the various surgical procedures performed for treatment of sigmoid volvulus. METHODS: A retrospective study of 111 patients with sigmoid volvulus treated at University Hospital in northern India during last six years was performed. RESULTS: Mean age for sigmoid volvulus was 51.1 +/- 15.3 years, with a male-to-female ratio of 2.5:1. Duration of symptoms was 4.3 +/- 2.6 days. Plain radiographs of the abdomen suggested the diagnosis in 76 cases (68.47 percent). Resection of the bowel was performed in 40 cases with gangrenous sigmoid colon and 6 cases with viable colon. Nonresectional procedure in the form of colocolopexy (fixation of sigmoid to transverse colon) or extraperitonealization was performed in 13 and 44 cases, respectively. Mortality was 6.3 percent (n = 7). No recurrence was seen after resection and extraperitonealization, whereas 5 of 13 cases (38.5 percent) had recurrence after colocolopexy. CONCLUSION: Resection and extraperitonealization of the sigmoid colon are the suitable alternatives for nongangrenous sigmoid volvulus. Colocolopexy is not indicated, because of the associated high recurrence rate.