Feasibility of single-stage resection and primary anastomosis in patients with acute noncomplicated sigmoid volvulus

Akçan, Alper; Akyıldız, Hızır; Artiş, Tarık; Yılmaz, Namık; Sözüer, Erdoğan

doi:10.1016/j.amjsurg.2006.08.077

Cited by 47 publications

(53 citation statements)

References 21 publications

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“…There is a large variation in the literature when one compares the outcome of resection and primary anastomosis versus colostomy. The findings of this study contrast with those of Aekan et al and Okello et al, where there was no significant difference between resection and primary anastomosis or colostomy in terms of morbidity and mortality 11,32 .…”

Section: Serum Electrolyte Levelscontrasting

confidence: 57%

Factors Influencing Outcome of Sigmoid Volvulus in Northern Uganda. A Prospective Observational Study

Wismayer¹

2017

East. Cent. Afr. J. Surg.

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Introduction: Sigmoid volvulus (SV) is one of the commonest causes of intestinal obstruction inUganda. The purpose of this study was to determine the factors influencing the outcome of SV in Northern Uganda. Methodology: A prospective observational study was conducted on 103 sigmoid volvulus patients admitted between January 2012 to December 2012 and surgically managed in 19 hospitals in Northern Uganda and followed up postoperatively for 30 days. Surgical management was by resection and primary anastomosis or Hartmann's procedure or double barrel colostomy. Patients 13 years and above with sigmoid volvulus and who had consented/Assented were included in the study and followed up to the 30 th postoperative day. Ethical approval for the study was obtained from the Institutional Review Committee of Gulu University and Uganda National Council for Science and Technology. Data analysis was carried out using STATA/IC version 12.1. The outcome events were uneventful recovery, morbidity and mortality. Results: Eighteen(17.48%) patients developed complications including wound sepsis 10 (9.7%); wound dehiscence 8(7.7%) and anastomotic leak 8(7.7%). There were 8 deaths, giving a mortality rate of 7.7%. The factors associated with a high risk of adverse outcome were hypernatraemia (RR=14.9; 95% CI: 1.46-152.9) and ileo-sigmoid knotting (RR = 4.94; 95% CI: 1.30-18.78). Resection and primary anastomosis had a better outcome compared to Hartmann's procedure (RR=0.15; 95% CI: 0.02-0.099). Conclusion: The risk factors associated with morbidity and mortality were preoperative hypernatraemia and ileo-sigmoid knotting. Colostomy was associated with a higher risk of morbidity and mortality than resection and primary anastomosis.

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Section: Serum Electrolyte Levelscontrasting

confidence: 57%

Factors Influencing Outcome of Sigmoid Volvulus in Northern Uganda. A Prospective Observational Study

Wismayer¹

2017

East. Cent. Afr. J. Surg.

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“…[18] Therefore, staged operations or primary anastomosis after intraoperative antegrade colonic lavage can be avoided without increasing morbidity and mortality rates. [20] Twenty-four (50.0%) of the patients in this series were found to have viable colon and had onestage resection and primary anastomosis without antegrade intraoperative colonic lavage. Two other patients with viable sigmoid colons had an initial rectal tube detortion and semi-elective sigmoidectomy and primary anastomosis after a routine bowel preparation on the same admission.…”

Section: Discussionmentioning

confidence: 98%

Acute sigmoid volvulus in a West African population

Ali

Jah

2010

Ann Afr Med

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“…In cases with dead intestine, resection and formation of a stoma are the necessary actions which must be taken. Even though many surgeons attempt primary anastomosis in cases with uncomplicated sigmoid volvulus, this requires further thought in pregnant patients as an anastomotic leak can result in major problems to the gravid uterus and fetus 2, 3, 8. In this case, the intestinal wall showed no signs of vascular compromise, so after unwinding and decompression, the sigmoid colon was put back in place.…”

Section: Discussionmentioning

confidence: 98%