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Feasibility of single-stage resection and primary anastomosis in patients with acute noncomplicated sigmoid volvulus.

Akcan A, Akyildiz H, Artis T, Yilmaz N, Sozuer E

Department of General Surgery, Erciyes University School of Medicine, Kayseri, Turkey. acakcan@erciyes.edu.tr

BACKGROUND: The management of sigmoid volvulus remains controversial. The aim of this study was to evaluate the feasibility of treating sigmoid volvulus by using a single-stage resection and anastomosis versus a 2-stage approach. METHODS: A total of 136 patients with noncomplicated sigmoid volvulus who had undergone emergency surgery within the last 15 years were evaluated retrospectively. Sigmoid resection plus Hartmann colostomy was performed in 45 patients, and sigmoid resection plus primary anastomosis was performed in 91 patients. In 40 of the patients who underwent a Hartmann procedure, we performed a second operation for colostomy closure (HC&CC group). RESULTS: There were no significant differences among the groups with regard to age, sex, morbidity, reoperation because of complications, mortality rates, and duration of intensive care unit stay (P > .05). The duration of hospital stay was significantly longer in the HC&CC group than in the other groups (P < .001). CONCLUSIONS: In cases without the complications of perforation or gangrene, sigmoid resection with immediate anastomosis was feasible. Single-stage operations did not increase morbidity or mortality rates, and patients required a shorter hospital stay than those who had undergone 2-stage operations.

Published 19 March 2007 in Am J Surg, 193(4): 421-6.
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