Forty-one consecutive patients with acute sigmoid
volvulus were prospectively randomized into 2 groups to compare percutaneous deflation prior to emergency tube
decompression followed electively by colopexy with banding (n = 20) versus emergency tube
decompression followed electively by sigmoid
colectomy (n = 21). Of 21 patients subjected to tube
decompression, the procedure was successful in 15 (71%). Emergency sigmoid
colectomy was done in the remaining 6 patients and 3 of them died postoperatively. Percutaneous deflation enabled all patients (n = 20) to have successful tube
decompression without complications. Two of the patients (13%) who underwent elective sigmoid
colectomy died postoperatively and another 2 developed
wound infections, whereas colopexy by banding caused no mortality and only 1 patient (5%) developed a
wound infection. Disconnection of the intravenous line, consumption of solid food, and discharge from the hospital were each effected at significantly (p less than 0.001) earlier postoperative times with colopexy than with sigmoid
colectomy. Both of these elective procedures were equally effective in preventing recurrence of the
volvulus. During 1 year of follow-up, colopexy was not observed to cause any
abdominal pain or alteration in bowel habits. This study shows that percutaneous deflation of acute sigmoid
volvulus is a rapid and safe method which enables successful sigmoidoscopic
decompression with avoidance of emergency surgery and its high mortality rates. The study also shows that colopexy by banding is a simple elective procedure which overcomes the limitations of mesenteropexy and resectional surgery.