AN OBSERVATIONAL STUDY ON VARIOUS METHODS OF MANAGEMENT OF SIGMOID VOLVULUS IN A TERTIARY CARE CENTRE

Abstract

AIMS AND OBJECTIVES: Volvulus refers to the twisting or axial rotation of a portion of the bowel around its mesenteric axis. It may be congenital or acquired, primary or secondary. The commonest spontaneous type in adults occurs in sigmoid colon. In this study, we compare the various methods of surgical intervention performed in sigmoid volvulus and its outcome. METHODS:This is a comparative study done on 26 patients presenting with sigmoid volvulus to the ER during the period of October 2018 to October 2021 in the department of General Surgery, Rajendra Institute of medical sciences, Ranchi. The procedures performed were sigmoidopexy, mesocoloplasty, resection and anastomosis with or without a diversion colostomy and Hartmann's procedure depending on the presentation, hemodynamics, bowel preparation and intra operative ndings of the patient. RESULTS:The most commonly performed procedure in the emergency setting was resection and anastomosis (32%) and mesocoloplasty (32%) and RA with diversion stoma (15%), sigmoidopexy (15%) and Hartmann's procedure (7%). The recovery percentage was about 90-95% in all procedures. CONCLUSION: Though there is lot of procedures done for sigmoid volvulus, there is no single ideal procedure of choice. It has to be decided in the operating room based on the ndings and general condition of the patient. Bowel resection was associated to have complications and increased duration of hospital stay when compared to non resective methods.