Colectomy for caecal and sigmoid volvulus: a national analysis of outcomes and risk factors for postoperative complications

Abstract

Aim Colonic volvulus is a common entity encountered by colorectal surgeons, but there are few reports of national data regarding postoperative outcomes. The aim of this study was to describe the volvulus population, 30‐day outcomes following right‐ and left‐sided colectomy and risk factors for postoperative complications. Method The American College of Surgeons National Surgical Quality Improvement Program Database from 2012 to 2015 was utilized to identify patients with the diagnosis of ‘volvulus’ who underwent right‐ or left‐sided colectomy. Primary outcomes were overall morbidity and mortality. Results A total of 2175 patients were identified (661 right colectomy and 1514 left colectomy). Risk factors for complications following right‐sided colectomy included: age, male gender, smoker, systemic inflammatory response syndrome, sepsis, septic shock and American Society of Anesthesiologsts class ≥ 4. Risk factors for complications following left‐sided colectomy included: age, male gender, systemic inflammatory response syndrome, sepsis and septic shock. Conclusion Several nonmodifiable risk factors were identified for complications following colectomy for volvulus. These risk factors can be used in patient/family counselling and discharge planning.

Comments on ‘Colectomy for caecal and sigmoid volvulus: a national analysis of outcomes and risk factors for postoperative complications’

“…Second, compared with my own series [3], the postoperative morbidity rate (46.4%) is similar; Althans et al [1] give an acceptable mortality rate (3.4%) in SV patients treated with colectomy and primary anastomosis, despite a high incidence of seriously ill patients (ASA score ≥ 4, 16.3%). After propensity score matching, Dolejs et al [8] reported a 10.8% mortality rate in 232 SV patients treated with emergency colectomy and primary anastomosis in the same period (between 2012 and 2015) by using the same database (American College of Surgeons National Surgical Quality Improvement Program).…”

“…Additionally, colectomy is used in the elective treatment of SV [5]. In the light of our comprehensive experience, I would like to discuss the data given by Althans et al [1] and some details of the authors' comments.…”

“…In the light of our comprehensive experience, I would like to discuss the data given by Althans et al . and some details of the authors' comments.…”

“…Second, compared with my own series , the postoperative morbidity rate (46.4%) is similar; Althans et al . give an acceptable mortality rate (3.4%) in SV patients treated with colectomy and primary anastomosis, despite a high incidence of seriously ill patients (ASA score ≥ 4, 16.3%). After propensity score matching, Dolejs et al .…”

Response to “Comments on ‘Colectomy for caecal and sigmoid volvulus: a national analysis of outcomes and risk factors for postoperative complications’”

“…I thank Professor Atamanalp for the thoughtful discussion regarding our paper entitled ‘Colectomy for caecal and sigmoid volvulus: a national analysis of outcomes and risk factors for postoperative complications’ . We would like to congratulate him on his cited work of 1026 patients with sigmoid volvulus as this is the largest series in the published literature .…”