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KMID : 1141920200360060403
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Annals of Coloproctology
2020 Volume.36 No. 6 p.403 ~ p.408
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Surgical Management of Sigmoid Volvulus: A Multicenter Observational Study
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Lee Keun-Chul
Oh Heung-Kwon
Cho Jung-Rae
Kim Min-Hyun
Kim Duck-Woo
Kang Sung-Bum
Kim Hyung-Jin
Park Hyoung-Chul
Shin Ru-Mi
Heo Seung-Chul
Ryoo Seung-Bum
Park Kyu-Joo
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Abstract
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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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KEYWORD
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Sigmoid volvulus, Laparoscopy, Elective surgery
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