Sigmoid volvulus treated by resection and primary anastomosis: urgent and elective conditions as risk factors for postoperative morbidity and mortality

Abstract

Purpose: Sigmoid volvulus is a major cause of intestinal obstruction. The aim of this study is to analyze urgent and elective conditions as risk factors for morbidity and mortality regarding sigmoid colon resection and primary anastomosis in patients with sigmoid volvulus.

Methods: This retrospective study included 63 patients diagnosed with sigmoid volvulus, who underwent sigmoid colon resection plus primary anastomosis under urgent or elective conditions between January 1994 and December 2010.

Results: Sigmoid colon resection plus anastomosis was performed in 63 patients; 31 (49.2 %) under urgent conditions, while 32 (50.8 %) were performed electively. The mean age of the patients was 65.2 ± 15.2 (18-95) years. The patients consisted of 50 (79.4 %) men and 13 (20.6 %) women. There were no statistical significances between groups in terms of age, gender, associated diseases, and hospital stay. Postoperative morbidity occurred in 30.2 % of patients. The morbidity rates for the urgent group and the elective group were 35.5 and 25.0 %, respectively (p = 0.419). Wound infection, pneumonia, and evisceration were the most common postoperative complications. Wound infection was higher in the urgent group (p = 0.026). In terms of other complications, the groups were similar. Total mortality occurred in 19.4 % of the urgent group and 15.6 % of the elective group (p = 0.750).

Conclusion: Sigmoid colon resection plus primary anastomosis-related morbidity and mortality rates were similar in patients who were operated on under urgent and elective conditions, and who maintained good general condition.

Keywords: Elective; Morbidity; Mortality; Sigmoid volvulus; Surgery; Urgent.