Sigmoid volvulus - Study from a north Indian hospital

PURPOSE: The aim of this study was to review our experience with sigmoid vo lvulus and to compare the various surgical procedures performed for treatme nt of sigmoid volvulus. METHODS: A retrospective study of 111 patients with sigmoid volvulus treated at University Hospital in northern India during l ast six years was performed. RESULTS: Mean age for sigmoid volvulus was 51. 1 +/- 15.3 years, with a male-to-female ratio of 2.5:1. Duration of symp to ms was 4.3 +/- 2.6 days. Plain radiographs of the abdomen suggested the dia gnosis in 76 cases (68.47 percent). Resection of the bowel was performed in 40 cases with gangrenous sigmoid colon and 6 cases with viable colon. Nonr esectional procedure in the form of colocolopexy (fixation of sigmoid to tr ansverse colon) or extraperitonealization was performed in 13 and 44 cases, respectively. Mortality was 6.3 percent (n = 7). No recurrence was seen af ter resection and extraperitonealization, whereas 5 of 13 cases (38.5 perce nt) had recurrence after colocolopexy. CONCLUSION: Resection and extraperit onealization of the sigmoid colon are the suitable alternatives for nongang renous sigmoid volvulus. Colocolopexy is not indicated, because of the asso ciated high recurrence rate.