CLINICAL RESEARCH
Impact of watch and wait procedure after endoscopic detorsion for sigmoid volvulus in high risk dementia patients
,
 
,
 
 
 
More details
Hide details
1
Department of General Surgery, Firat University Hospital, Elazig, Turkey
 
 
Submission date: 2020-11-19
 
 
Final revision date: 2021-01-31
 
 
Acceptance date: 2021-02-07
 
 
Publication date: 2021-04-16
 
 
Arch Med Sci Civil Dis 2021;6(1):12-17
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Volvulus is defined as an acute bowel dilatation, which must be treated after the diagnosis in a short time, which otherwise can cause necrosis and perforation of the bowel. Chronic constipation and neurological diseases are the most common causes in some countries. In this study, patients with sigmoid volvulus who were treated and followed up were examined, the association of it with neurological diseases was investigated, and the demographic characteristics of the patients, treatment approaches, and results were presented.

Material and methods:
Patients who underwent colonic volvulus with dementia between January 2010 and August 2020 were retrospectively reviewed. The demographic characteristics and histopathological diagnosis of the patients were recorded. Differences in treatment modalities and results of patients with volvulus were statistically analyzed.

Results:
Seventy-eight patients who had sigmoid volvulus and dementia were included the study. The median age was 82.0 years and males represented 71.8% of the patients. All the patients had abdominal pain, while the other common symptoms were vomiting, abdominal distension and constipation. The complication rate was statistically significantly higher in surgical treatment than endoscopic procedures and spontaneously detorsioned (p = 0.011). The median length of stay was statistically significantly different in the surgery group, endoscopic procedure group and spontaneously detorsioned group (p < 0.001).

Conclusions:
The prevalence of volvulus is high in individuals with neurological disease. Successful results were obtained with non-surgical follow-up after endoscopic detorsion in the selected patient group in the results of this study, and mortality and morbidity were at lower rates than surgery.

REFERENCES (25)
1.
Ifversen AKW, Kjaer DW. More patients should undergo surgery after sigmoidvolvulus. World J Gastroenterol 2014; 20: 18384-9.
 
2.
Perrot I, Fohlen A. Management of colonic volvulus in 2016. J Visc Surg 2016; 153: 183-92.
 
3.
Frank L, Moran A. Use of percutaneous endoscopic colostomy (PEC) to treat sigmoid volvulus: a systematic review. Endosc Int Open 2016; 4: e737-41.
 
4.
Poirier AA, Aubé B, Côté M, et al. Gastrointestinal dysfunctions in Parkinson’s disease: symptoms and treatments. Parkinsons Dis 2016; 2016: 6762528.
 
5.
Toebosch S, Tudyka V. Treatment of recurrent sigmoid volvulus in Parkinson’s disease by percutaneous endoscopic colostomy. World J Gastroenterol 2012; 18: 5812-5.
 
6.
Safioleas M, Chatziconstantinou C. Clinical considerations and therapeutic strategy for sigmoid volvulus in the elderly: a study of 33 cases. World J Gastroenterol 2007; 13: 921-4.
 
7.
Renzulli P, Maurer CA, Netzer P, Büchler MW. Preoperative colonoscopic derotation is beneficial in acute colonic volvulus. Dig Surg 2002; 19: 223-9.
 
8.
Shepherd JJ. Treatment of volvulus of sigmoid colon: a review of 425 cases. Br Med J 1968; 1: 280-3.
 
9.
Shepherd JJ. The epidemiology and clinical presentation of sigmoid volvulus. Br J Surg 1969; 56: 353-9.
 
10.
Hasnaoui H, Laytimi F, Elfellah Y, et al. Transverse colon volvulus presenting as bowel obstruction: a case report. J Med Case Rep 2019; 13: 156.
 
11.
Grossmann EM, Longo WE, Stratton MD, Virgo KS, Johnson FE. Sigmoid volvulus in department of veterans affairs medical centers. Dis Colon Rectum 2000; 43: 414-8.
 
12.
Oren D, Atamanalp SS, Aydinli B, et al. An algorithm for the management of sigmoid colon volvulus and the safety of primary resection: experience with 827 cases. Dis Colon Rectum 2007; 50: 489-97.
 
13.
Turan M, Sen M, Karadayi A, et al. Our sigmoid colon volvulus experience and benefits of colonoscope in detortion process. Rev Esp Enferm Dig 2004; 96: 32-5.
 
14.
Gingold D, Murrell Z. Management of colonic volvulus. Clin Colon Rectal Surg 2012; 25: 236-44.
 
15.
Atamanalp SS. Treatment of sigmoid Volvulus: a single-center experience of 952 patients over 46.5 years. Tech Coloproctol 2013; 17: 561-9.
 
16.
Atamanalp SS, Ozturk G. Sigmoid volvulus in the elderly: outcomes of a 43-year, 454-patient experience. Surg Today 2011; 41: 514-9.
 
17.
Sutcliffe MM. Volvulus of the sigmoid colon. Br J Surg 1968; 55: 903-10.
 
18.
Sule AZ, Iya D, Obekpa PO, Ogbonna B, Momoh JT, Ugwu BT. One-stage procedure in the management of acute sigmoid volvulus. J R Coll Surg Edinb 1999; 44: 164-6.
 
19.
Ozdemir S, Aslar AK, Kuzu MA. Sigmoid volvulus: long-term surgical outcomes and review of the literature.
 
20.
S Afr J Surg 2012; 50: 9-15.
 
21.
Larkin JO, Thekiso TB, Waldron R, Barry K, Eustace PW. Recurrent sigmoid volvulus-early resection may obviate later emergency surgery and reduce morbidity and mortality. Ann R Coll Surg Engl 2009; 91: 205-9.
 
22.
Swenson BR, Kwaan MR, Burkart NE, et al. Colonic volvulus: presentation and management in metropolitan Minnesota, United States. Dis Colon Rectum 2012; 55: 444-9.
 
23.
Halabi WJ, Jafari MD, Kang CY, et al. Colonic volvulus in the United States: trends, outcomes, and predictors of mortality. Ann Surg 2014; 259: 293-301.
 
24.
Dolejs SC, Guzman MJ, Fajardo AD, Holcomb BK, Robb BW, Waters JA. Contemporary management of sigmoid volvulus. J Gastrointest Surg 2018; 22: 1404-11.
 
25.
Bhatnagar BNS, Sharma CLN, Gautam A, Kakar A, Reddy DCS. Gangrenous sigmoid volvulus: a clinical study of 76 patients. Int J Colorectal Dis 2014; 19: 134-42.
 
ISSN:2451-0637
Journals System - logo
Scroll to top