Surgical Management of Sigmoid Volvulus: A Multicenter Observational Study
- Author:
Keunchul LEE
1
;
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
;
Author Information
- Publication Type:Original Article
- From:Annals of Coloproctology 2020;36(6):403-408
- CountryRepublic of Korea
- Language:English
-
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 patients, 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.
