Primary Resection - Anastomosis in Sigmoid Volvulus

ABSTRACT

Colonic volvulus is a disease of the geriatric population. It is common in the developing countries. The optimal management of this disease remains controversial. During the period from June 1999 to December 2002, 42 patients [29 males and 13 females] with left colonic obstruction that proved after exploration to be due to sigmoid volvulus were included in this study [their mean age was 67 years]. All cases underwent exploration and primary resection. After intraoperative colonic lavage, primary anastomosis without a defunctioning proximal colostomy was done for all cases. Of these cases, 43 passed the postoperative period smoothly without complications, while 5 cases showed a subclinical leakage and developed wound infection that was managed by conservative treatment. In this series, the mortality, due to unavoidable complications, was 7.1%. The postoperative hospital stay ranged from 8 to 18 days with a mean of 11 days. This study showed that primary resection-anastomosis in cases with sigmoid volvulus could shorten the hospital stay and avoid the morbidity of colostomy without any significant increase in mortality and morbidity