Outcomes for sigmoid volvulus managed with and without early definitive surgery: 20‐year experience in a tertiary referral centre

Satheakeerthy, Shriranshini; Leow, Priscilla; Hall, Benjamin; Yen, Damien Ah; Fischer, Jesse

doi:10.1111/ans.18671

Cited by 5 publications

(2 citation statements)

References 17 publications

(37 reference statements)

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“…In the patient group with acute cholecystitis, which is another risky surgery requirement and CCI determines the risk of preoperative mortality, complications were more common in those with CCI>6 [37]. Satheakeerthy et al found the median CCI score to be 4 in their study [38]. In the same study, they followed up 48% of the patients non-operatively and reported that recurrence developed in 63%.…”

Section: Discussionmentioning

confidence: 94%

Clinicopathological Features of Elderly Patients with Colonic Volvulus

Gul,

Oğuz Aşlayan,

Çorbacı

et al. 2024

Eur J Ther

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Objective: Sigmoid volvulus is most commonly seen in patients between 60 and 80 years old. The management of volvulus depends on its location and clinical presentation. The fundamental aspects of treatment include evaluating the viability of the colon, relieving the obstruction, and preventing the possibility of recurrence. We aimed to present the clinicopathological characteristics of geriatric colonic volvulus patients treated in a single center. Methods: Patients diagnosed with colonic volvulus and treated in this hospital were included in the study. Mortality rates of patients who underwent and did not undergo preoperative colonoscopic detorsion were compared statistically. In addition, diseases that affect the quality of life and cause deterioration in bowel movements and habits were determined, and these diseases' effect on mortality was evaluated. Results: Forty-four patients who underwent emergency surgery due to volvulus were included in our study. There was sigmoid colon perforation in two patients and cecum perforation in 1 patient. Two patients had cecal volvulus, and right hemicolectomy was performed in these patients; anastomosis was performed in one, and ileostomy was performed in the other. Sigmoid resection was performed in 36 patients, subtotal colectomy in 5 patients, right hemicolectomy in 2 patients, and sigmoidopexy with laparotomy and reduction in 1 patient. Thirteen patients (29.5%) underwent preoperative colonoscopy, and in eight cases, the procedure was conducted a day before the surgery, with the operation being carried out semi-urgently the next day. Conclusion: Intestinal volvulus is a rare condition that can occur in any part of the large intestine. However, it is a severe medical issue that requires prompt diagnosis and treatment due to the possibility of intestinal damage and mortality.

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Section: Discussionmentioning

confidence: 94%

Clinicopathological Features of Elderly Patients with Colonic Volvulus

Gul,

Oğuz Aşlayan,

Çorbacı

et al. 2024

Eur J Ther

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“…

We read the article written by Satheakeerthy et al 1 on the acute and elective treatment of sigmoid volvulus (SV). Our comments relate to the details of SV management based on our 1071-case experience treated over 57-year period from June 1966 to July 2023, which series contains the most comprehensive single-centre SV data over the world.

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confidence: 99%

Re: Outcomes for sigmoid volvulus managed with and without early definitive surgery: 20‐year experience in a tertiary referral centre

Atamanalp,

Disci,

Peksoz

2023

ANZ Journal of Surgery

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We read the article written by Satheakeerthy et al. 1 on the acute and elective treatment of sigmoid volvulus (SV). Our comments relate to the details of SV management based on our 1071-case experience treated over 57-year period from June 1966 to July 2023, which series contains the most comprehensive single-centre SV data over the world. 2 In SV, current guidelines advise flexible endoscopic decompression in patients without bowel ischaemia and perforation. 3 Although rigid endoscopes are commonly used due to their availability, accessibility, and cheapness, most practitioners favour flexible instruments over rigid endoscopes because of their higher success and lower complication rates. 4 Hence, in our 777-case endoscopy experience, the success rates are 84.8% versus 81.8%, while the mortality and morbidity rates are 0.2% versus 0.9% and 1.2% versus 2.6%, respectively, in flexible and rigid endoscopy groups. In this series, bowel perforation was seen in one of 351 patients (0.3%) treated with rigid endoscope. Nevertheless, we exactly disused rigid endoscopes in 2003. However, 5-case perforation ratio (3.0% in 168 trying) in the authors' series is relatively high. Inadequate visualization, severe manipulation, excessive air insufflation, and blind flatus tube application are common causes of perforation. 4 Second, current guidelines recommend elective sigmoid colectomy with primary anastomosis in selected patients. 3 Elective surgery may be performed with acceptable mortality (0%-2% vs. 1%-30%) and morbidity (5%-15% vs. 5%-60%) rates when compared with that of acute surgery, as was demonstrated by the authors. Hence, in our series, the mortality and morbidity rates are 0% and 11.3%, respectively, in 115-case elective surgery group, while these rates are 17.3% and 34.2%, respectively, in 486-patient acute surgery group. We recommend elective surgery, particularly laparoscopic procedure, in most American Society of Anesthesiologists score 1-3 cases younger than 75 years old. 2 We congratulate the authors and we look forward to their reply.

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Response: Sigmoid volvulus in pregnancy: A rare case report

Pfeiffer,

Clark,

Sullivan

et al. 2024

Intl J Gynecology & Obste

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We have been asked by the Editors of the International Journal of Gynecology & Obstetrics to comment on the preceding rebuttal 1 of our case report on sigmoid volvulus (SV) in pregnancy. 2 Out of several types of large-bowel obstruction, colonic volvulus is less common in the United States and Europe, while it has high prevalence in Indian subcontinent, Africa, and the Middle East. SV accounts for a majority of all the reported cases of colonic volvulus. 3

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Outcomes for sigmoid volvulus managed with and without early definitive surgery: 20‐year experience in a tertiary referral centre

Cited by 5 publications

References 17 publications

Clinicopathological Features of Elderly Patients with Colonic Volvulus

Clinicopathological Features of Elderly Patients with Colonic Volvulus

Re: Outcomes for sigmoid volvulus managed with and without early definitive surgery: 20‐year experience in a tertiary referral centre

Response: Sigmoid volvulus in pregnancy: A rare case report

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