One stage procedure in the management of acute sigmoid volvulus without colonic lavage

Background: There is a growing acceptance of one-stage primary resection and anastomosis of left-sided colon obstruction with on-table antegrade colonic lavage to reduce the risk of post-operative infectious complications and anastomotic dehiscence. The purpose of this study was to evaluate the safe...

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Bibliographic Details
Published in:The surgeon (Edinburgh) 2007-10, Vol.5 (5), p.268-270
Main Authors: Sule, A.Z, Misauno, M, Opaluwa, A.S, Ojo, E, Obekpa, P.O
Format: Article
Language:English
Subjects:
acute sigmoid volvulus
Adult
Aged
Aged, 80 and over
Anastomosis, Surgical - methods
Colectomy - methods
colonic lavage
Decompression, Surgical - methods
Female
Follow-Up Studies
Humans
Intestinal Volvulus - surgery
intra-operative
Male
Middle Aged
One-stage procedure
Prospective Studies
Rectum - surgery
Sigmoid Diseases - surgery
Surgery
Treatment Outcome
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Summary:Background: There is a growing acceptance of one-stage primary resection and anastomosis of left-sided colon obstruction with on-table antegrade colonic lavage to reduce the risk of post-operative infectious complications and anastomotic dehiscence. The purpose of this study was to evaluate the safety of single-stage resection and anastomosis for acute left-sided colonic obstruction due to acute sigmoid volvulus, without intraoperative colonic lavage, in a consecutive series of patients admitted to our department. Methods: Emergency resection of acute sigmoid volvulus was performed by an experienced senior surgeon (consultant grade). This was followed by primary anastomosis without on-table colonic lavage after a manual decompression. Results: A total of 21 patients underwent bowel decompression, resection and primary colorectal anastomosis. Two of the patients who had ileosigmoid knotting and gangrenous bowel had double resection with primary ileoileal and colorectal anastomosis. There were two superficial wound infections. No death or clinical anastomotic failure were recorded in this series. The mean hospital stay was 10.3 days. Conclusion: Our results suggest that resection of acute sigmoid volvulus and primary anastomosis after decompression alone can be carried out safely in reasonably tit patients.
ISSN:1479-666X
2405-5840
DOI:10.1016/S1479-666X(07)80023-0