Abstract
Abstract
Aim. The aim of this retrospective study is to assess the mortality and morbidity after different types operations for sigmoid volvulus. Method. The results of surgical treatment of our patients with sigmoid volvulus were analyzed retrospectively. The patients were divided into two groups: Group-1: Single Stage Surgery (SSS) and Group-2: Hartmann’s Procedure (HP). Results. Total 51 patients aged 65.9 years in average (between 22-88 years) were included. In comparing the morbidity rates of SSS group to the HP group, it revealed no statistically significant differences. All died patients (12/51, 25.5%) were above 70 years old and had comorbidities. Overall, there were 12 patients (12/51, 23.52%) with sigmoid colon necrosis at exploratory laparotomy. While 4 of them were in SSS group, 8 of them were in HP group. Three of four (75%) sigmoid colon necrosis patients in SSS group, and 4 of 8 sigmoid colon necrosis patients in (50%) HP group were died. Conclusion. We want to notice that, there would be a high risk of complication, if the situation accompanies a sigmoid colon necrosis at laparotomy. Late admisson and patient’s negative general condition also play an important role in anastomosis safety.
Keywords: Sigmoid volvulus, Hartmann’s procedure, single stage surgery.
Özet
Amaç. Bu retrospektif çalışmanın amacı sigmoid volvulus tedavisinde gerçekleştirilen iki farklı yaklaşımın mortalite ve morbide üzerine farklılıklarını değerlendirmektir. Yöntemler. Sigmoid volvulus tedavisi uygulanan hastaların sonuçları retrospektif olarak irdelendi. Hastalar Grup-1: Tek aşamalı cerrahi ve Grup-2: Hartmann Yöntemi (HY) olmak üzere iki gruba ayrıldı. Bulgular. Yaş ortalaması 65.9 yıl (22-88 yıl) olan toplam 51 hasta çalışmaya dahil edilmiştir. Grup-1 ile Grup-2’nin morbidite ve mortalite sonuçlarının karşılaştırılması sonucunda istatistiksel olarak anlamlı bir sonuç çıkmamıştır. Kaybedilen tüm hastaların (n=12, %25,5) yandaş problemleri vardır ve yaşları 70 ve üzeridir. Hastaların 12’sinde (%23,52) laparotomide sigmoid kolon nekrozu ile karşılaşılmış ve bu hastaların 7’si (%58) kaybedilmiştir. Sonuç. Bu çalışmada vurgulamak istediğimiz en önemli şey laparotomide sigmoid kolon nekrozu ile karşılaşılmış ise komplikasyon oranının yüksek olacaği şeklindedir. Hastanın hastaneye başvuruda gecikmesi ve eşlik eden sorunlar anastomoz güvenliğinde önemli faktörlerdir.
Anahtar sözcükler: Sigmoid volvulus, Hartmann Yöntemi, tek aşamalı cerrahiReferences
- Cozart JC, Clouse RE. Gastric Volvulus as a Cause of Intermittent Dysphagia. Dig Dis Sci 1997; 43: 1057-60.
- Yaseen ZH, Watson RE, Dean HA, Wilson ME. Case report: transverse colon volvulus in a patient with Clostridium difficile pseudomembranous colitis. Am J Med Sci 1994; 308: 247-50.
- Jones IT, Fazio VW. Colonic volvulus. Etiology and management. Dig Dis 1989; 7: 203-9.
- Oludiran OO, Osime OC. Emergency one-stage resection without mechanical bowel preparation for acute sigmoid volvulus. J Med Biomed Res 2004; 3: 86-90. Jones HJ, de Cossart L. Risk scoring in surgical patients. Br J Surg 1999; 86: 149-5
- Madiba TE, Thomson SR. The management of cecal volvulus. Dis Colon Rectum 2002; 45: 264-7.
- Oren D, Atamanalp SS, Aydinli B, Yildirgan MI, Başoğlu M, Polat KY, Onbaş O. An algorithm for the management of sigmoid colon volvulus and the safety of primary resection: experience with 827 cases. Dis Colon Rectum 2007; 50: 4899
- Sinha RS. A clinical appraisal of volvulus of the pelvic colon with special reference to aetiology and treatment. Br J Surg 1969; 56: 838-40.
- Mishra SB, Sahoo KP. Primary resection and anastomosis for volvulus of sigmoid colon. J Indian Med Assoc 1986; 84: 265-8.
- Faranisi CT. An approach to the management of volvulus of the sigmoid colon. Cent Afr J Med 1990; 36: 31-3.
- Larkin JO, Thekiso TB, Waldron R, Barry K, Eustace PW. Recurrent sigmoid volvulus - early resection may obviate later emergency surgery and reduce morbidity and mortality. Ann R Coll Surg Engl 2009; 91: 205-9.
- Safioleas M, Chatziconstantinou C, Felekouras E, Stamatakos M, Papaconstantinou I, Smirnis A, Safioleas P, Kostakis A. Clinical considerations and therapeutic strategy for sigmoid volvulus in the elderly: a study of 33 cases. World J Gastroenterol 2007; 13: 921-4.
- Tsai MS, Lin MT, Chang KJ, Wang SM, Lee PH. Optimal interval from decompression to semi-elective operation in sigmoid volvulus. Hepatogastroenterology 2006; 53: 354-6.
- Cirocchi R, Farinella E, La Mura F, Morelli U, Trastulli S, Milani D, Di Patrizi MS, Rossetti B, Spizzirri A, Galanou I, Kopanakis K, Mecarelli V, Sciannameo F. The sigmoid volvulus: surgical timing and mortality for different clinical types. World J Emerg Surg 2010; 5: 1.
- Degiannis E, Levy RD, Sliwa K, Hale MJ, Saadia R. Volvulus of the sigmoid colon at Baragwanath Hospital. S Afr J Surg 1996; 34: 25-8.
- Jumbi G, Kuremu RT. Emergency resection of sigmoid volvulus. East Afr Med J 2008; 85: 398-405.
- Akcan A, Akyildiz H, Artis T, Yilmaz N, Sozuer E. Feasibility of single-stage resection and primary anastomosis in patients with acute noncomplicated sigmoid volvulus. Am J Surg 2007; 193: 421-6.
- Ağaoğlu N, Yücel Y, Türkyilmaz S. Surgical treatment of the sigmoid volvulus. Acta Chir Belg 2005; 105: 365-8.
- Belgerden S , Taviloğlu K, Caglıkülekci M, Ertekin C, Kurtoglu M. Immediate resection and anastomosis in sigmoid colon volvulus (analysis of 32 cases). Turkiye Klinikleri J Med Res 1994; 12: 78-82.
- De U. Sigmoid volvulus in rural Bengal. Trop Doct 2002; 32: 80-2.
- Suleyman O, Kessaf AA, Ayhan KM. Sigmoid volvulus: long-term surgical outcomes and review of the literature. S Afr J Surg 2012; 14; 50: 9-15.
- Osiro SB, Cunningham D, Shoja MM, Tubbs RS, Gielecki J, Loukas M. The twisted colon: a review of sigmoid volvulus. Am Surg 2012; 78: 271-9.
Abstract
Amaç. Bu retrospektif çalışmanın amacı sigmoid volvulus tedavisinde gerçekleştirilen iki farklı yaklaşımın mortalite ve morbide üzerine farklılıklarını değerlendirmektir. Yöntemler. Sigmoid volvulus tedavisi uygulanan hastaların sonuçları retrospektif olarak irdelendi. Hastalar Grup-1: Tek aşamalı cerrahi ve Grup-2: Hartmann Yöntemi (HY) olmak üzere iki gruba ayrıldı. Bulgular. Yaş ortalaması 65.9 yıl (22-88 yıl) olan toplam 51 hasta çalışmaya dahil edilmiştir. Grup-1 ile Grup-2’nin morbidite ve mortalite sonuçlarının karşılaştırılması sonucunda istatistiksel olarak anlamlı bir sonuç çıkmamıştır. Kaybedilen tüm hastaların (n=12, %25,5) yandaş problemleri vardır ve yaşları 70 ve üzeridir. Hastaların 12’sinde (%23,52) laparotomide sigmoid kolon nekrozu ile karşılaşılmış ve bu hastaların 7’si (%58) kaybedilmiştir. Sonuç. Bu çalışmada vurgulamak istediğimiz en önemli şey laparotomide sigmoid kolon nekrozu ile karşılaşılmış ise komplikasyon oranının yüksek olacaği şeklindedir. Hastanın hastaneye başvuruda gecikmesi ve eşlik eden sorunlar anastomoz güvenliğinde önemli faktörlerdir.
References
- Cozart JC, Clouse RE. Gastric Volvulus as a Cause of Intermittent Dysphagia. Dig Dis Sci 1997; 43: 1057-60.
- Yaseen ZH, Watson RE, Dean HA, Wilson ME. Case report: transverse colon volvulus in a patient with Clostridium difficile pseudomembranous colitis. Am J Med Sci 1994; 308: 247-50.
- Jones IT, Fazio VW. Colonic volvulus. Etiology and management. Dig Dis 1989; 7: 203-9.
- Oludiran OO, Osime OC. Emergency one-stage resection without mechanical bowel preparation for acute sigmoid volvulus. J Med Biomed Res 2004; 3: 86-90. Jones HJ, de Cossart L. Risk scoring in surgical patients. Br J Surg 1999; 86: 149-5
- Madiba TE, Thomson SR. The management of cecal volvulus. Dis Colon Rectum 2002; 45: 264-7.
- Oren D, Atamanalp SS, Aydinli B, Yildirgan MI, Başoğlu M, Polat KY, Onbaş O. An algorithm for the management of sigmoid colon volvulus and the safety of primary resection: experience with 827 cases. Dis Colon Rectum 2007; 50: 4899
- Sinha RS. A clinical appraisal of volvulus of the pelvic colon with special reference to aetiology and treatment. Br J Surg 1969; 56: 838-40.
- Mishra SB, Sahoo KP. Primary resection and anastomosis for volvulus of sigmoid colon. J Indian Med Assoc 1986; 84: 265-8.
- Faranisi CT. An approach to the management of volvulus of the sigmoid colon. Cent Afr J Med 1990; 36: 31-3.
- Larkin JO, Thekiso TB, Waldron R, Barry K, Eustace PW. Recurrent sigmoid volvulus - early resection may obviate later emergency surgery and reduce morbidity and mortality. Ann R Coll Surg Engl 2009; 91: 205-9.
- Safioleas M, Chatziconstantinou C, Felekouras E, Stamatakos M, Papaconstantinou I, Smirnis A, Safioleas P, Kostakis A. Clinical considerations and therapeutic strategy for sigmoid volvulus in the elderly: a study of 33 cases. World J Gastroenterol 2007; 13: 921-4.
- Tsai MS, Lin MT, Chang KJ, Wang SM, Lee PH. Optimal interval from decompression to semi-elective operation in sigmoid volvulus. Hepatogastroenterology 2006; 53: 354-6.
- Cirocchi R, Farinella E, La Mura F, Morelli U, Trastulli S, Milani D, Di Patrizi MS, Rossetti B, Spizzirri A, Galanou I, Kopanakis K, Mecarelli V, Sciannameo F. The sigmoid volvulus: surgical timing and mortality for different clinical types. World J Emerg Surg 2010; 5: 1.
- Degiannis E, Levy RD, Sliwa K, Hale MJ, Saadia R. Volvulus of the sigmoid colon at Baragwanath Hospital. S Afr J Surg 1996; 34: 25-8.
- Jumbi G, Kuremu RT. Emergency resection of sigmoid volvulus. East Afr Med J 2008; 85: 398-405.
- Akcan A, Akyildiz H, Artis T, Yilmaz N, Sozuer E. Feasibility of single-stage resection and primary anastomosis in patients with acute noncomplicated sigmoid volvulus. Am J Surg 2007; 193: 421-6.
- Ağaoğlu N, Yücel Y, Türkyilmaz S. Surgical treatment of the sigmoid volvulus. Acta Chir Belg 2005; 105: 365-8.
- Belgerden S , Taviloğlu K, Caglıkülekci M, Ertekin C, Kurtoglu M. Immediate resection and anastomosis in sigmoid colon volvulus (analysis of 32 cases). Turkiye Klinikleri J Med Res 1994; 12: 78-82.
- De U. Sigmoid volvulus in rural Bengal. Trop Doct 2002; 32: 80-2.
- Suleyman O, Kessaf AA, Ayhan KM. Sigmoid volvulus: long-term surgical outcomes and review of the literature. S Afr J Surg 2012; 14; 50: 9-15.
- Osiro SB, Cunningham D, Shoja MM, Tubbs RS, Gielecki J, Loukas M. The twisted colon: a review of sigmoid volvulus. Am Surg 2012; 78: 271-9.
Details
| Primary Language | English |
|---|---|
| Journal Section | Surgical Science Research Articles |
| Authors | |
| Publication Date | June 27, 2013 |
| Published in Issue | Year 2013Volume: 35 Issue: 2 |