Abstract | INTRODUCTION: Sigmoid volvulus typically occurs in older patients who have multiple co-morbidities. Therefore, often, a conservative approach to management is chosen. However, there is little data on long-term outcomes of this approach in Australasia. The aim of this study was to review the recurrence and mortality outcomes of patients admitted to Dunedin Hospital with sigmoid volvulus. METHODS: All cases of sigmoid volvulus admitted to the Department of General Surgery at Dunedin Hospital from January 1989 to January 2009 were identified using a prospective database, the Otago Clinical Audit. Mortality data was accessed from the National Births and Deaths Registry. RESULTS: Fifty-seven patients, median age of 68, were included in the study with 84 admissions for sigmoid volvulus. A total of 39 of the 57 patients ultimately had surgery, 26 on the index admission. Thirty-one patients (61%) treated conservatively at index admission had a recurrence at a median of 31 days. Forty-two per cent of the patients treated conservatively a second time suffered a further recurrence at a median of 144 days. There was no recurrence in patients who had surgery. There was no in-hospital mortality reported in either group. There was one anastomotic leak in the surgical group. Minor complications included ileus, respiratory infections, urinary tract infection and a hernia. CONCLUSION: Early elective operation for cases of sigmoid volvulus is encouraged in patients without prohibitive co-morbidities as this study shows a high recurrence rate in conservatively managed patients and a low morbidity and mortality in surgically managed patients.
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Authors | Omid Yassaie, Mark Thompson-Fawcett, Jeremy Rossaak |
Journal | ANZ journal of surgery
(ANZ J Surg)
Vol. 83
Issue 1-2
Pg. 74-8
(Jan 2013)
ISSN: 1445-2197 [Electronic] Australia |
PMID | 22924840
(Publication Type: Evaluation Study, Journal Article)
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Copyright | © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons. |
Topics |
- Aged
- Colectomy
- Elective Surgical Procedures
- Female
- Humans
- Intestinal Volvulus
(mortality, surgery, therapy)
- Kaplan-Meier Estimate
- Length of Stay
(statistics & numerical data)
- Male
- Patient Readmission
(statistics & numerical data)
- Postoperative Complications
- Recurrence
- Sigmoid Diseases
(mortality, surgery, therapy)
- Sigmoidoscopy
- Treatment Outcome
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