Sigmoidectomy following sigmoid volvulus: who is at risk of anastomotic failure?

Left sided gallbladder and liver without situs inversus and recurrent sigmoid volvulus after alleged previous total sigmoid resection; a case report and review of literatures

“…The option of doing primary resection and anastomosis versus Hartmann's colostomy should be individualized to the patients' condition and the status of bowel. Male sex, prolonged duration of symptoms (>72 h), edematous megacolon and gangrenous obstruction found to have increased risk of anastomotic leak after primary resection and anastomosis [16] , [17] . Taking these facts into consideration and the experience in our set up, we did Hartmann's colostomy with a plan for subsequent takedown/ reversal of the colostomy.…”

Sigmoid volvulus and diabetes mellitus

“…Although DM prevalence in regional population is stated as 8.3%, 6 when case reports and small case series are excluded, the rate of the co-occurrence of SV and DM is reported to be between 2.6% and 41.1% (mean 15.7%) in the literature (Table-II). 3,4,[7][8][9][10][11][12][13][14][15][16][17][18] 12 and Althans et al 13 demonstrated 12.1% and 10.6% of DM incidences in relatively large multicenter SV series including 2,538 and 1,514 cases, respectively.…”

Comments on 'Sigmoidectomy following sigmoid volvulus: who is at risk of anastomotic failure?'

“…Dear Sir, I read with interest the article written by Tankel et al [1] on risk factors affecting anastomotic leakage following elective sigmoidectomy and primary anastomosis in patients with sigmoid volvulus (SV). In the light of our 55-year (June 1966-July 2021) and 1040-case experience with SV, which is the largest single-center series in the world [2], I wish to discuss some details in SV management.…”

“…First, according to the authors' evaluation, age > 80 years and American Society of Anesthesiologists (ASA) class 3-4 are associated with an increased risk of anastomotic leakage [1]. Although age alone is a controversial criterion in the elective treatment of SV, it is well known that the high incidence of comorbid diseases in advanced age increases mortality and morbidity [3].…”

“…Regarding surgical practice, I wonder about the indications of elective Hartmann's procedure used in 17 patients (17.2%) in the series evaluated by the authors [1]. Although stoma is a life-saving procedure in the emergency surgical treatment of selected high-risk, bed-bound, and elderly patients [4], sigmoidectomy and primary anastomosis, preferably laparoscopic, is preferable in the elective surgical treatment of SV [3].…”