Akademik Veri Yönetim Sistemi
European Congress of Trauma and Emergency Surgery 2020, Oslo, Norveç, 26 - 28 Nisan 2020, ss.129
Introduction: Treatment options for sigmoid volvulus are decided by
its severity. Uncomplicated cases are usually treated by endoscopic
detorsion followed by elective surgery and complicated cases or cases
can’t be detorsioned are treated with emergency surgery. In this study
we aim to review a single center experience in long term management
of sigmoid volvulus cases.
Material and methods: Data of the sigmoid volvulus cases between
2009–2018 were collected using hospital database. Files of 57
patients were reviewed for treatment modalities, demographic info
and complications. 4 patients were dropped from the study due to
inadequate long term follow-up.
Results: 37 were men and 16 were women. Mean age was 54,9.
Endoscopic detorsion was attempted in 30 cases. Success rate was
90% (n = 27). 10 of these patients were followed up with elective
surgery. 23 patients with complicated cases and 3 unsuccessful
detorsion patients were managed by emergency surgery. 16 hartman
procedures, 10 anterior resections, 2 left hemicolectomies, 1 subtotal
colectomy and 2 transverse loop colostomies were done. A stoma was
created in 28 cases. 22 patients had their stoma created in the primary
surgery and an additional of 6 stomas were created due to anastomosis
leakage. Mortality rate in the first 7 days was 25% (n = 7) in patients
with a stoma (n = 28). ASA and Charlson co-morbidity scores were
exceptionally high in the mortality group. In the remaining patient
group, stoma closure rate was 57.1%.
Conclusions: Endoscopic detorsion is a powerful and highly successful
management option in uncomplicated cases when done by an
experienced staff. Emergency surgery shouldn’t be delayed in complicated
cases or after unsuccessful detorsion attempts.