Experimental and clinical study in the treatment of sigmoid volvulus.

The aim of the study was to introduce an alternative surgical procedure for the treatment of primary volvuius of the sigmoid colon. Sigmoid colon plication was performed in 42 dogs, and afterwards in six patients. The procedure consists of systematic plaiting the sigmoid colon wall with interrupted serosubmucosal 3/0 Vicryl sutures along the whole circumference, except on the mesenteric border. Five parallel circular folds were done in dogs, and 20-30 folds in patients, with appropriate bowel length reduction. In the experimental study, dogs were randomly divided into three experimental and one control group of 14 animals each. The group 1 dogs were sacrificed on day 8, group 2 dogs on day 15, and group 3 and control group dogs on day 30 postoperatively. On exploration, sigmold colon adhesions were found in 6 (14.3%) animals. Intestinal wall and lumen were normal. In the clinical study, six patients with sigmoid volvulus were operated on within 6-8 hours of admission. A viable colon was a prerequisite for the sigmoid plication procedure. The operating time was 60-90 minutes. Recovery was uneventful, with average hospitalization 11 (range 8-15) days. No volvulus recurrence was recorded during the three-year follow-up. Based on our experimental and clinical data, we believe that the plication procedure could be appropriate treatment in some selected patients with volvulus of the sigmold colon.