The Outcome of Resection and Primary Anastomosis (With On-table Lavage) Management of Acute Sigmoid Volvulus, A Developing Country Experience

Abstract

Background: Acute sigmoid volvulus is the third most common cause of large bowel obstruction. It occurs when the sigmoid part of the colon twists around its blood supply. Methodology: This is a retrospective cross-sectional study detailing the outcome of 15 patients with acute sigmoid volvulus who underwent resection of the affected part of the colon and primary resection with on-table lavage in Khartoum, Sudan in the period from January 2019 to January 2021. All 15 patients were recruited on the basis of their fitting status for surgery and their consent to the procedure. All patients have been followed-up for a period of 2 months post-operatively with no loss to follow-up. Results: The outcome for all 15 patients was excellent with no complications. All patients have been followed up for a period of 2 months following their surgeries. There was no loss to follow-up among them and all of them have attended their post-operative follow up clinics. There were no reported wound problems of dehiscence and infection, anastomotic leakages or the need for revision surgery. Patients have a mean age of 46 years. One of the participants was a Jehovah’s witness; therefore, a cautious approach was implemented during surgery. Another one of the participants were suffering from left hip fracture when he underwent surgery, requiring a high level of care during his pre, peri as well as post-operative care. Conclusion and Recommendation: The outcome for resection and primary anastomosis with on-table lavage can be excellent with no complications. One limitation of this study, as this is not a comparative study, is that no comparison between the outcome of such procedure with the Hartmann’s procedure approach to managing such a condition. We recommend large-scale comparison between the outcome for both approaches to managing acute sigmoid volvulus.