Is Primary Resection And Anastomosis, Without Proximal Stoma Safe In Gangrenous Sigmoid Volvulus?

Is Primary Resection And Anastomosis, Without Proximal Stoma Safe In Gangrenous Sigmoid Volvulus?

Author Dileep Singh Thakur
Co-Author Jitin Bajaj, Deepti Bala Sharma, Dhananjaya Sharma
DOI

Country : India
Subject : Surgery

Keywords : Colon, Gangrene, Intestinal Volvulus, Sigmoid, Surgical Anastomosis, Volvulus

Abstract

Introduction: Management of Sigmoid volvulus includes non-operative and operative measures. Our aim was to study the safety and efficacy of Emergency resection and primary anastomosis (ERPA) in viable and gangrenous sigmoid volvulus without a proximal colostomy.
Material & Methods: It was a prospective observational study at a single centre of seventy-four months duration. Included cases of both viable and gangrenous sigmoid volvulus were subjected to ERPA without proximal stoma. Hemodynamically unstable patients were excluded. Primary outcomes studied were leak, abdominal abscess, wound infection and mortality. Follow up period was one month.
Results: Total sixty-four cases comprising of fifty-one males and thirteen females came under the inclusion criteria. There were two cases of leak (3%), two cases of abdominal abscess (3%), thirteen cases of wound infection (20%), and no mortality.
Conclusion: ERPA is a safe and effective option for both viable and sigmoid volvulus in expert hands and in hemodynamically stable patients.

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