Ann Coloproctol.
2020 Dec;36(6):403-408. 10.3393/ac.2020.03.23.
Surgical Management of Sigmoid Volvulus: A Multicenter Observational Study
- Lee K1
- Oh HK
1 - Cho JR1
- Kim M1
- Kim DW1
- Kang SB1
- Kim HJ2
- Park HC3
- Shin R4
- Heo SC4
- Ryoo SB5
- Park KJ5
- Seoul Colorectal Research Group (SECOG)
- Affiliations
-
- 1Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- 2Department of Surgery, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
- 3Department of Colorectal Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
- 4Department of Surgery, Seoul Metropolitan GovernmentSeoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
- 5Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- KMID: 2510804
- DOI: http://doi.org/10.3393/ac.2020.03.23
Abstract
- Purpose
This study aimed to evaluate real-world clinical outcomes from surgically treated patients for sigmoid volvulus.
Methods
Five tertiary centers participated in this retrospective study with data collected from October 2003 through September 2018, including demographic information, preoperative clinical data, and information on laparoscopic/open and elective/emergency procedures. Outcome measurements included operation time, postoperative hospitalization, and postoperative morbidity.
Results
Among 74 patients, sigmoidectomy was the most common procedure (n = 46), followed by Hartmann’s procedure (n = 23), and subtotal colectomy (n = 5). Emergency surgery was performed in 35 cases (47.3%). Of the 35 emergency patients, 34 cases (97.1%) underwent open surgery, and a stoma was established for 26 patients (74.3%). Elective surgery was performed in 39 cases (52.7%), including 21 open procedures (53.8%), and 18 laparoscopic surgeries (46.2%). Median laparoscopic operation time was 180 minutes, while median open surgery time was 130 minutes (P < 0.001). Median postoperative hospitalization was 11 days for laparoscopy and 12 days for open surgery. There were 20 postoperative complications (27.0%), and all were resolved with conservative management. Emergency surgery cases had a higher complication rate than elective surgery cases (40.0% vs. 15.4%, P = 0.034).
Conclusion
Relative to elective surgery, emergency surgery had a higher rate of postoperative complications, open surgery, and stoma formation. As such, elective laparoscopic surgery after successful sigmoidoscopic decompression may be the optimal clinical option.
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