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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Sep 28, 2008; 14(36): 5590-5594
Published online Sep 28, 2008. doi: 10.3748/wjg.14.5590
Resection and primary anastomosis with or without modified blow-hole colostomy for sigmoid volvulus
Sacid Coban, Mehmet Yilmaz, Alpaslan Terzi, Fahrettin Yildiz, Dincer Ozgor, Cengiz Ara, Saim Yologlu, Vedat Kirimlioglu
Sacid Coban, Department of General Surgery, Gaziantep University School of Medicine, Gaziantep 27310, Turkey
Mehmet Yilmaz, Dincer Ozgor, Cengiz Ara, Vedat Kirimlioglu, Department of General Surgery, Inonu University School of Medicine, Malatya 44280, Turkey
Alpaslan Terzi, Fahrettin Yildiz, Department of General Surgery, Harran University School of Medicine, Sanliurfa 63200, Turkey
Saim Yologlu, Department of Biostatistics, Inonu University School of Medicine, Malatya 44280, Turkey
Author contributions: Coban S and Yilmaz M contributed equally to this work; Coban S, Yilmaz M, Ozgor D, Ara C and Kirimlioglu V designed and performed the research; Terzi A, Yildiz F and Yologlu S analyzed data; and Coban S, Terzi A, Yildiz F wrote the paper.
Correspondence to: Sacid Coban, MD, Department of General Surgery, Gaziantep University School of Medicine, Gaziantep 27310, Turkey. sacitcoban@yahoo.com
Telephone: +90-342-3601200-76330 Fax: +90-342-3601013
Received: June 9, 2008
Revised: August 11, 2008
Accepted: August 18, 2008
Published online: September 28, 2008
Abstract

AIM: To evaluate the efficacy of resection and primary anastomosis (RPA) and RPA with modified blow-hole colostomy for sigmoid volvulus.

METHODS: From March 2000 to September 2007, 77 patients with acute sigmoid volvulus were treated. A total of 47 patients underwent RPA or RPA with modified blow-hole colostomy. Twenty-five patients received RPA (Group A), and the remaining 22 patients had RPA with modified blow-hole colostomy (Group B). The clinical course and postoperative complications of the two groups were compared.

RESULTS: The mean hospital stay, wound infection and mortality did not differ significantly between the groups. Superficial wound infection rate was higher in group A (32% vs 9.1%). Anastomotic leakage was observed only in group A, with a rate of 6.3%. The difference was numerically impressive but was statistically not significant.

CONCLUSION: RPA with modified blow-hole colostomy provides satisfactory results. It is easy to perform and may become a method of choice in patients with sigmoid volvulus. Further studies are required to further establish its role in the treatment of sigmoid volvulus.

Keywords: Acute sigmoid volvulus; Anastomosis; Primary resection; Surgical technique