Sigmoidopexy (tube sigmoidostomy) as definitive surgical procedure for sigmoid volvulus.

ABSTRACT

BACKGROUND: Volvulus of the sigmoid colon is associated with high mortality and high recurrence rate following nonoperative decompression of the colon. Therefore definitive surgery is required for its management. AIM: To evaluate the outcome following sigmoidopexy (tube sigmoidostomy) as a definitive surgical procedure to prevent recurrence of disease. METHODS: Seventeen patients with sigmoid volvulus who presented with features of large gut obstruction were studied; 12 patients underwent elective and 5 underwent emergent exploratory laparotomy. Malecot catheter fixed to the sigmoid colon and abdominal wall acted as fixator for the colon and rent for drainage of fecal matter. RESULTS: Sigmoidostomy started functioning the day following surgery and the stoma remained patent for approximately 12 days, although discharge started decreasing by the 5th postoperative day. No recurrence was noted over a period of 18 (5) months (range 13-23). CONCLUSIONS: Tube sigmoidostomy is an alternative effective procedure to prevent recurrence of sigmoid volvulus in patients who present without gangrene.