Surgical Management of Sigmoid Volvulus: A Multicenter Observational Study

• Published in: Annals of coloproctology Vol. 36; no. 6; pp. 403 - 408
• Main Authors: Lee, Keunchul, Oh, Heung-Kwon, Cho, Jung Rae, Kim, Minhyun, Kim, Duck-Woo, Kang, Sung-Bum, Kim, Hyung-Jin, Park, Hyoung-Chul, Shin, Rumi, Heo, Seung Chul, Ryoo, Seung-Bum, Park, Kyu Joo
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Coloproctology 01.12.2020; 대한대장항문학회
• Subjects: elective surgery; laparoscopy; Original; sigmoid volvulus; 일반외과학; Elective surgery; Laparoscopy; Sigmoid volvulus
• ISSN: 2287-9714; 2287-9722
• DOI: 10.3393/ac.2020.03.23

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.