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SIGMOID VOLVULUS: WHAT HAS CHANGED IN THE LAST 50 YEARS?

Sabri Selcuk Atamanalp
Ataturk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
Esra Disci
Ataturk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
Refik Selim Atamanalp
Ataturk University, Faculty of Medicine, English Medicine Section, Erzurum, Turkey
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  • Articles
  • Submited: December 2, 2016
  • Published: September 20, 2017

Abstract

Background: Sigmoid volvulus (SV) is the wrapping of the sigmoid colon around itself. The aim of this study is to evaluate the changes in SV from past to present.

Methods: The clinical records of 993 patients treated over a 50-year period between June 1966 and June 2016 were analyzed, retrospectively until June 1986 (612 patients), and prospectively thereafter (381 patients).

Results: The incidence decreased over the last 25 years (p<0.001). Although the patients' age, gender, history, and comorbidity rate were similar, the symptom duration shortened (p<0.001), and the rate of shock decreased (p<0.005). The clinical presentation did not change. Non-operative therapeutic procedures were most commonly used (p<0.001), and flexible endoscopy took the place of barium enema and rigid endoscopy (p<0.001). Although the success rate of the non-operative procedures increased (p<0.001) and the hospitalization period shortened (p<0.001), rates of morbidity, mortality, and recurrence did not change. The pre-operative diagnostic accuracy rate increased (p<0.001). The need for surgical treatment, as well as volvulus direction and over rotation rate were similar, while bowel gangrene was seen less often (p<0.05).  Non-resectional surgical methods were used less frequently (p<0.001), and resection with primary  anastomosis generally took the place of the resection with stoma (p<0.005). The morbidity and mortality rates of the surgery decreased (p<0.05, for each) and the hospitalization period shortened (p<0.001), while the recurrence rate did not change.

Conclusions: We observed a decrease in the incidence of SV as well as changes in the diagnostic and therapeutic strategies, and an improvement in the prognosis, while the clinical features did not change.

Key words: Sigmoid colon, Volvulus, Intestinal obstruction, Diagnosis, Treatment

 

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How to Cite
Atamanalp, S. S., Disci, E., & Atamanalp, R. S. (2017). SIGMOID VOLVULUS: WHAT HAS CHANGED IN THE LAST 50 YEARS?. Ethiopian Medical Journal, 55(4). Retrieved from https://emjema.org/index.php/EMJ/article/view/566

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