Risk of recurrence of sigmoid volvulus: a single‐centre cohort study

Abstract

In our cohort, the recurrence rate of sigmoid volvulus following successful nonoperative decompression was high. Still, more than 20% of patients did not experience a recurrence after their first episode. Nonoperative decompression could thus be suggested as the sole treatment for the first episode of volvulus. However, after the second episode it is probable that early planned surgery would improve outcome and reduce health-care consumption.

Perioperative Outcomes and Predictors of Mortality After Surgery for Sigmoid Volvulus

“…There is a 78.4% chance recurrence after initial nonoperative treatment, 87.9% after second, and 89.8% after subsequent episodes. 13 High mortality rates up to 40% are associated with recurrent volvulus. 4,7,12 Owing to this, many studies have come to recommend that emergency decompression be followed by elective operative resection.…”

Garnaflækja á bugaristli á Landspítala 2000-2013

“…2,6 Þekkt er að endurkoma sjúkdóms geti átt sér stað í allt að 84% tilvika eftir ristilspeglun og telja því flestir að líta þurfi á ristilspeglun þar sem létt er á snúningi ristils sem bráðabirgðameðferð fyrir endanlega meðferð með skurðaðgerð ef sjúklingur er á annað borð faer í aðgerð. 1,5,7,8 Sumir höfundar hafa lagt til að endanleg meðferð með skurðaðgerð eigi að fara fram sem flýti-valaðgerð (semi-elective) innan tveggja til fimm sólarhringa frá ristilspeglun ef aðstaeður leyfa. 5,9 Það skapar rými til að meðhöndla meðfylgjandi sjúkdóma og undirbúa sjúkling frekar fyrir skurðaðgerð.…”

Comments on ‘Recurrence risk of sigmoid volvulus – a single‐centre cohort study’

“…Detorsion using a rectal tube under radiological screening, as described by the authors, is an alternative nonoperative detorsion procedure. Their mortality rate was 2.4%, which is higher than that of endoscopic detorsion procedures . Blind nonoperative detorsion procedures, including enema and rectal tube applications, even if under radiological screening, have a risk of missing bowel ischemia or gangrene, and a possibility of bowel perforation and peritonitis.…”

“…I congratulate the authors again for their interesting presentation and look forward to their reply on my comments. 10 Dear Editor, We are grateful for the comments made by Professor Atamanalp [1] based on his clinical experience.…”

“…It would be useful to have clearer guidelines to assist decision making in the management of this common condition. Dear Sir, Rectal cancer is the third most common cancer worldwide and the fourth most common cause of cancer death [1]. The incidence of lateral pelvic lymph nodes is 8.6% for all rectal cancers [2] and is mostly seen in cancers of the lower rectum and in advanced cases [3].…”